Closure of the Azygos Vein With Polymer Clip in 13 Cases Undergoing Thoracoscopic-Laparoscopic Esophagectomy

Abstract

INTRODUCTION: In this study, we aimed to discuss the cases that azygos vein were closed with polymer clip in which the cases underwent MIMcKeown esophagectomy. METHODS: Between May 2014-May 2016, 13 cases who underwent MI McKeown esophagectomy due to esophageal cancer in our center were included in the study. RESULTS: The mean age of the cases was 53.8 years, 10 were female and 3 were male. Tumor localization was middle esophagus in 10 cases and lower esophagus in 3 cases. While neoadjuvant chemoradiotherapy has received 11 cases were received 2 cases. 10 patients underwent thoracoscopic-laparoscopic oesophagectomy, and 3 patients underwent thoracotomic-laparoscopic oesophyectomy. In all cases, azygos vein was closed with polymer clip and esophagogastrostomy was performed in the cervical region. The mean operative time was 210 min. The mean hospital stay was 12.9 days. 4 patients had pathological complete response. The mean number of lymph nodes removed was 9.6. In 2 cases, chylothorax developed as a complication and one of them died on the 26th day. None of the cases had any complications and bleeding due to azygos vein. DISCUSSION AND CONCLUSION: While In the case of esophageectomy, the use of the polymer clip in the closure of the azygous vein, which is one of the major vascular structures, does not increase the risk of complications and bleeding, superiority in terms of cost and ease of use. Therefor we believe that it can be used safely.

Keywords

• minimally invasive esophagectomy
• mckeown esophagectomy
• azygos vein.