PS02.151: ESOPHAGEAL CANCER RESECTION AND AZYGOS LOBE

Abstract Background Azygos lobe is a congenital variation of the upper lobe of the right lung and is seen in 1% of the population. Esophagectomy is usually performed through a right thoracotomy, so the 1% of the esophagectomy require a treatment for the change from azygos lobe. We report a case of the thoracoscopic approach in the prone position in patient admitted for esophageal carcinoma and azygos lobe. Methods We herein describe a 71-year-old male with esophageal carcinoma associated with azygos lobe. The procedures of our surgical techniques were as follows: (1) The patient was placed in prone position. (2) Two 12mm-trocars and two 5mm-trocar were used. (3) Subtotal esophagectomy and lymphadenectomy was performed with the arch of the azygos vein cutting by using the right-sided thoracoscopic approach in addition to the laparotomy. (4) Retrosternal esophagogastrostomy was performed for reconstruction. Results Operative time was 375 min. Blood loss was 170 g, and no perioperative transfusion was required. Postoperative recovery was uneventful. Histology showed the resection margins were clear. Surgical findings were as follows: (1) The azygos lobe was easily found in the upper mediastinum. (2) The azygos vein and the membrane was into the apex of the lung. (3) Cutting both of them, whole esophagus was clear without the arch of the azygos vein. (4) Esophagus was effectively stripped with no disturbance of the arch of the azygos vein. Conclusion The described procedure for esophageal carcinoma and azygos lobe is a minimally invasive alternative to the conventional thoracotomy that looks promising. Disclosure All authors have declared no conflicts of interest.