J.Jpn. Surg. Soc.. 90(11): 1866-1872, 1989

---

Original article

A STUDY ON THE CHANGES OF THE TRACHEO-BRONCHIAL MUCOSA AFTER ESOPHAGECTOMY FOR ESOPHAGEAL CANCER; WITH A SPECIAL REFERENCE TO THE INFLUENCE OF NECK AND UPPER MEDISTINAL LYMPH NODE DISSECTIONS

The tracheo-bronchial mucosa of 27 surgical patients with esophageal cancer was examined by bronchofiberscope postoperatively, and the changes of the mucosa were divided into four grades, i.e., GI: no change or slight redness only (7 cases), GII: Severe redness or erosion (7 cases), GIII: Ulcer formation (11 cases) and GIV: Necrosis of the mucosa (2 cases).
All the GI-III changes were reversible. However, GIV change was irreversible. The biopsy specimens were taken from the mucosa of the tracheal bifurcation on the 7th postoperative day, showing squam ous metaplasia in 9 of 13 patients.
Bilateral modified neck and upper mediastinal lymph node dissections were performed in 18 of 27 patients. The change of the mucosa was judged as GIII or IV in 12 of 18 patients (67%), whereas the change was less significant in the remaining 6 patients. Namely, the degree of mucosal change did not necessarily correspond with the extent of lymph node dissection.
The changes of the mucosa were considered to be brought about not only by tracheo-bronchial ischemia but also by injurious effects on the pulmoanry parenchym following aggressive lymph node dissection. The assessment of the degree of the mucosal change might be a useful indicator for postoperative management of esophageal cancer patient.

---

---

To read the PDF file you will need Adobe Reader installed on your computer.