Unfavourable Vascular Anatomy for Esophageal Reconstruction: a Case for Chemoradiation in Operable Esophageal Cancer

Excerpt

Esophagectomy is the primary treatment of esophageal cancer except in a small number of screen detected cases where endoscopic resections can be undertaken. Majority of the cases with esophageal cancer present with a locally advanced disease requiring neoadjuvant treatment followed by esophagectomy. The patients with esophageal cancer are advised definitive chemoradiation if the disease is unresectable in view of extensive locoregional spread [1, 2]. Following esophagectomy, the bowel continuity is maintained using a bowel conduit as an esophageal replacement. A number of surgical options using stomach, colon, or jejunum are available in the armamentarium of surgeons for esophageal replacement. We present a case report of a patient with a potentially resectable esophageal cancer, who was denied surgery in view of unfavourable anatomy for esophageal reconstruction. He was advised definitive chemoradiation. This case report highlights the importance of detailed radiological assessment of vascular anatomy prior to esophagectomy. …