Laparoscopic Transhiatal Esophagectomy With En Bloc Posterior Tracheal Wall Resection

Esophageal adenoid cystic carcinoma is a rare cancer that is a challenge to treat because the tumor often invades local structures. Complete resection with grossly negative margins is key to disease-free survival. We describe a case in which the esophageal tumor invaded a significant portion of the posterior trachea, making a tracheal resection with primary anastomosis impossible. Therefore, to resect the tumor completely, we performed a laparoscopic esophagectomy and posterior tracheal resection with tracheoplasty using a rotational flap while the patient was on venovenous extracorporeal membrane oxygenation.