Esophagectomy Combined With Aortic Segment Replacement for Esophageal Cancer Invading the Aorta Zhuangzhuang Cong, MD, Qiang Diao, MD, Jun Yi, MD, PhD,

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Esophagectomy Combined With Aortic Segment Replacement for Esophageal Cancer Invading the Aorta Zhuangzhuang Cong, MD, Qiang Diao, MD, Jun Yi, MD, PhD, Lei Xiong, MD, Haiwei Wu, MD, PhD, Tao Qin, MD, Hua Jing, MD, Demin Li, MD, Yi Shen, MD, PhD The Annals of Thoracic Surgery Volume 97, Issue 2, Pages 460-466 (February 2014) DOI: 10.1016/j.athoracsur.2013.10.028 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Plain and (B) enhanced chest computed tomographic scans of same patient, suggestive of clinical invasion of esophageal carcinoma (EC) into aorta. The Annals of Thoracic Surgery 2014 97, 460-466DOI: (10.1016/j.athoracsur.2013.10.028) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Overview of operation. (A) Descending aorta was intercepted by aortic forceps between distal and proximal sites of tumor-invading aorta. (B, C) Artificial thoracic vascular graft was sutured to margins of aorta, with tight adhesion between tumor and aortic segment not separated. (D) Mobilized stomach was lifted to esophageal bed, and cervical anastomosis was performed. (E) Esophagus and tumor-bearing aortic segment were resected en bloc. (F) Histopathologic invasion of EC into aortic tunica adventitia (hematoxylin and eosin staining, ×200 magnification). (AVG = artificial vascular graft; Es = esophagus; IDAo = intercepted distal aorta; LN = lymph node; RAoS = resected aortic segment.) The Annals of Thoracic Surgery 2014 97, 460-466DOI: (10.1016/j.athoracsur.2013.10.028) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Survival rate (A) for all 47 patients, (B) according to pathologic N status, and (C) according to postoperative therapies. The Annals of Thoracic Surgery 2014 97, 460-466DOI: (10.1016/j.athoracsur.2013.10.028) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions