Perioperative management of esophagectomy in a patient who previously underwent bilateral lung transplantation

JA Clinical Reports
Hiroaki ToyamaMasanori Yamauchi

Abstract

General theory of anesthetic managements for nontransplant procedures in lung transplant patients was proposed. However, there are few literatures reporting the perioperative management of thoracoabdominal major surgery following lung transplantation in detail. Herein, we scrupulously report a perioperative management of esophagectomy in a patient who previously underwent bilateral lung transplantation (BLTx), focusing on protection of the transplanted lungs and the respiratory function of the patient. A 50-year-old woman was listed for cadaveric BLTx for severe respiratory failure due to end-stage diffuse panbronchiolitis. She underwent BLTx under veno-arterial extracorporeal membranous oxygenation support. Blood loss during the BLTx was 13,675 mL, and mild lung edema developed. She was weaned from the ventilator on the sixth postoperative day (POD) and discharged on the 65th POD. Two years after the BLTx, respiratory function improved markedly, but she was diagnosed with esophageal cancer and was scheduled for thoracoscopic esophagectomy with radical lymph node dissection, hand-assisted laparoscopic gastric mobilization, and anastomosis of the gastric conduit to the cervical esophagus via posterior mediastinum. We were concer...Continue Reading

References

May 10, 2003·American Journal of Respiratory and Critical Care Medicine·Makoto SugitaYves Berthiaume
Apr 12, 2005·The Journal of Thoracic and Cardiovascular Surgery·D V PilcherT J Williams
Dec 19, 2009·The Journal of Immunology : Official Journal of the American Association of Immunologists·Tina DietrichClaus Cursiefen
Apr 28, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·R D YusenS Murray
Jul 30, 2010·The Annals of Thoracic Surgery·Alexey DashkevichHans Joachim Geissler
Sep 14, 2011·Journal of Clinical Anesthesia·Paolo FeltraccoCarlo Ori
Nov 3, 2011·JAMA : the Journal of the American Medical Association·Eric A EngelsMonica Lin
Oct 21, 2015·The Journal of Clinical Investigation·Ye CuiSouheil El-Chemaly

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