Thoracoscopic esophagectomy in the prone position for corrosive stricture after esophageal perforation due to balloon dilatation

An 18-year-old man was referred to our hospital because of chest pain after ingestion of a strong hydroxide in an attempted suicide. On post-ingestion day 25, an esophageal endoscopy and esophagram revealed at least three strictures, one each in the cervical, upper, and lower thoracic esophagus. In particular, the upper thoracic esophageal stricture was severe and was 5 cm long. Repeated balloon dilatation was employed, but resulted in perforation of the upper thoracic esophagus on the fourth attempt. On post-ingestion day 95, thoracoscopic esophagectomy in the prone position was performed. The esophagus was reconstructed using a subtotal gastric tube and cervical esophagogastric anastomosis in the supine position. Although the periesophageal adhesions were severe, esophagectomy was successfully performed. Anastomotic leakage developed after surgery, but the patient was discharged on postoperative day 47 on a regular diet.