Tracheobronchial anomaly: One-lung ventilation difficulty during thoracoscopic esophagectomy for esophageal cancer

Hiroyuki Kitagawa, Tomoaki Yatabe, Tsutomu Namikawa, Jun Iwabu, Sunao Uemura, Kazune Fujisawa, Sachi Tsuda, Hiromichi Maeda, Michiya Kobayashi, Kazuhiro Hanazaki

Research output: Contribution to journalArticlepeer-review


We describe a case of difficult deflation of the upper right lobe caused by the existence of a tracheobronchial anomaly during the thoracoscopic esophagectomy. A 70-year-old man with a history of myocardial infarction and dysphagia was diagnosed with thoracic esophageal squamous cell carcinoma. Endoscopy revealed a type 2 tumor in the lower esophagus and a superficial lesion in the middle esophagus and computed tomography showed no evidence of metastasis. We performed 2 courses of neo-adjuvant chemotherapy followed by thoracoscopic esophagectomy. During surgery, one-lung ventilation using right bronchus balloon occlusion was performed. However, the upper lobe of the right lung did not deflate, and upper mediastinal dissection was difficult. Intraoperative bronchoscopy revealed a right tracheal bronchus arising from just under the bifurcation. We reviewed the preoperative 3-dimensional computed tomography, which showed the right tracheal bronchus causing intraoperative incomplete deflation of the upper lobe. We recommend investigating this anomaly with 3-dimensional computed tomography before thoracoscopic esophagectomy.

Original languageEnglish
Pages (from-to)33-35
Number of pages3
JournalAnnals of Cancer Research and Therapy
Issue number1
Publication statusPublished - 2018

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research
  • Pharmacology (medical)


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