Abstract
Left brachiocephalic vein injury has not yet been reported during reconstruction after esophagectomy. A 58-year-old male patient was diagnosed with cervical esophageal squamous cell carcinoma and subsequently underwent subtotal esophagectomy followed by neo-adjuvant chemotherapy. The left brachiocephalic vein was accidentally injured when making a retrosternal space. The brachiocephalic vein was ligated followed by rapid sternotomy, and cervical esophagostomy without tumor resection and jejunostomy were performed for damage control. Complete resection of the cervical esophageal tumor and free jejunal transplantation for reconstruction were performed 55 days after the initial surgery. The patient is now well and has survived for more than 34 months after the reconstruction. Surgeons should consider left brachiocephalic vein injury when making a retrosternal space. Damage control surgery and preparation for a second surgery may be important in cases of accidental major vascular injury during esophagectomy.
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10388-014-0439-3/MediaObjects/10388_2014_439_Fig1_HTML.jpg)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10388-014-0439-3/MediaObjects/10388_2014_439_Fig2_HTML.jpg)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10388-014-0439-3/MediaObjects/10388_2014_439_Fig3_HTML.jpg)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10388-014-0439-3/MediaObjects/10388_2014_439_Fig4_HTML.jpg)
Similar content being viewed by others
References
Robbs JV, Reddy E. Management options for penetrating injuries to the great veins of the neck and superior mediastinum. Surg Gynecol Obstet. 1987;165:323–6.
Hines GL. Avulsion of the innominate vein during median sternotomy. J Cardiovas Surg. 1981;22:349–52.
Baumgartner FJ, Rayhanabad J, Bongard FS, Milliken JC, Donayre C, Klein SR. Central venous injuries of the subclavian-jugular and innominate-caval confluences. Tex Heart Inst J. 1999;26:177–81.
Nair R, Robbs JV, Muckart DJ. Management of penetrating cervicomediastinal venous trauma. Eur J Vasc Endovasc Surg. 2000;19:65–9.
Tachimori Y, Ozawa S, Fujishiro M, Matsubara H, Numasaki H, Oyama T, Shinoda M, Toh Y, Udagawa H, Uno T. Comprehensive Registry of Esophageal Cancer in Japan, 2006. Esophagus 2014;11:21–47.
Ethical Statement
This article does not contain any studies with human or animal subjects performed by any authors.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Shimada, Y., Okumura, T., Hashimoto, I. et al. Left brachiocephalic vein injury during esophagectomy. Esophagus 12, 290–294 (2015). https://doi.org/10.1007/s10388-014-0439-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10388-014-0439-3