Although salvage esophagectomy after definitive chemoradiation is more invasive than standard esophagectomy and causes many complications, some reports indicate that salvage surgery is more effective than other therapeutic options in recurrent esophageal cancer. Safer surgical procedures must be set for salvage esophagectomy. We conducted salvage esophagectomy under mediastinoscopy for middle and lower esophageal cancer. Case 1 : A 56-year-old man diagnosed with stage II esophageal cancer, experienced tumor growth following chemoradiation. Because the tumor was localized in the lower esophagus, we conducted esophagectomy under mediastinoscopy to minimize invasiveness the patient. Minor leakage in the postoperative course was cured with conservative therapy. Case 2 : A 54-year-old man diagnosed with stage II esophageal cancer, and undergoing chemoradiation developed esophageal perforation and mediastinitis during therapy that were cured with coservative therapy. At the end of the second course of chemotherapy, he suffered severe esophageal narrowing, so we conducted transhiatal esophagectomy under mediastinoscopy. His postoperative course was good and he was discharged on postoperative day 16.
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