Media Release

Udupi, Jan 9: A 62-year-old lady presented with difficulty in swallowing and was detected to have cancer in the middle part of the food pipe in the chest. She had one extra arch of aorta (major artery) connecting the ascending and descending aorta, where the food pipe and windpipe were completely encircled by two arches of aorta and lower part of food pipe was pushed to left side of chest. Normally, everyone has a single arch of aorta and right-sided lower esophagus. After completion of radiotherapy. The patient underwent Video-Assisted Thoracoscopic Surgery (VATS) (keyhole) without opening the chest.

"Keyhole surgery for cancer of the middle part of the food pipe following radiotherapy is always a challenge due to the close vicinity of the arch of the aorta, bronchi (branches of the windpipe). In this patient, because of the vascular anomaly, surgery was more difficult and challenging. The cancer of the food pipe was completely removed by the keyhole surgery through the right side of the chest, which is the first report in the literature as per our knowledge," said Dr Naveen.

Normally, after removing the chest part of the food pipe, continuity is maintained by bringing the stomach through the chest in the original path of the food pipe and joined to the upper part of the food pipe in the neck. In this the stomach tube was brought through the right side of the chest, lateral to the arch of the aorta, to prevent narrowing and block caused by two arches of aorta, if brought up in the routine path.

The surgery was performed by Dr Naveena Kumar A N and assisted by Dr Nawaz, Dr Keshav and Dr Athulya. The anesthesia was managed by Dr Manjunath Prabhu and Dr Yogesh Gaude. The patient was discharged on the tenth postoperative day without any major problems and she was able to eat a normal diet.

Dr Avinash Shetty, medical superintendent, Kasturba Hospital, Manipal congratulated the team led by Dr Naveen for accomplishing this complicated surgery and said, “It gives more hope to patients in Udupi the neighbouring districts. Currently, the surgical oncology department performs a large number of food pipe cancer surgeries through VATS (keyhole), which avoids opening of chest, big scar, blood loss, severe pain and which hastens patient recovery."