We report an unusual complication of laparoscopic esophagectomy for carcinoma. During posterior transhiatal dissection, massive bleeding occurred from the left side of the supradiaphragmatic thoracic aorta. A small tear was clearly visible and temporary bleeding control by packing and pressure with a grasper through one of the trocars was effective. A median laparotomy was performed and the aorta was sutured using a standard laparoscopic needle holder. The esophagectomy was successfully completed through a right thoracic approach. Injury to the intrathoracic aorta may occur during transhiatal dissection of the lower mediastinum. Use of a laparoscopic needle holder allowed to repair the supradiaphragmatic aorta through a laparotomy without the need of patient repositioning for a transthoracic approach.
|Titolo:||Injury of the thoracic aorta during laparoscopic esophagectomy|
|Autori interni:||BONAVINA, LUIGI (Primo)|
BONA, DAVIDE (Secondo)
|Parole Chiave:||Aortic injury; Esophageal carcinoma; Esophagectomy; Thoracic aorta|
|Settore Scientifico Disciplinare:||Settore MED/18 - Chirurgia Generale|
|Data di pubblicazione:||apr-2009|
|Digital Object Identifier (DOI):||10.1097/SLE.0b013e3181a02ff3|
|Appare nelle tipologie:||01 - Articolo su periodico|
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