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Surgical Case Reports
Fig. 3 | Surgical Case Reports

Fig. 3

From: Bilateral video-assisted thoracic surgery for esophageal cancer with left inferior pulmonary vein invasion following chemoradiation therapy

Fig. 3

Preoperative strategy and intraoperative procedure. We considered that video-assisted thoracic surgery (VATS) esophagectomy with left lung ventilation could be challenging after left lung resection. Therefore, we preoperatively planned three necessary steps as follows: (1) left-sided VATS only to observe and determine resectability and the range of lung resection, (2) right-sided VATS for esophagectomy, and (3) left-sided VATS for completing lung resection and en bloc esophagectomy. However, the range of lung resection intraoperatively was smaller than we expected, and it would not affect one-lung ventilation during esophagectomy in the right-sided VATS. Our procedure needed only two steps, < 1 > left-sided VATS for partial lower lobe resection and < 2 > right-sided VATS for esophagectomy. We also needed to move the patient to the supine position for tracheal tube exchange

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