Esophagectomy for esophageal cancer in a patient with protein C deficiency: A case report

Naoto Ujiie, Yusuke Taniyama, Hiroshi Okamoto, Chiaki Sato, Kai Takaya, Toshiaki Fukutomi, Takashi Kamei

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A 63-year-old man with protein C deficiency underwent thoracoscopic esophagectomy and digestive reconstruction using a gastric tube for thoracic esophageal cancer. On postoperative day 3, the gastric tube was removed because of anastomotic leakage and gastric tube necrosis. Digestive reconstruction using a free jejunal graft was attempted 140 days after the first surgery. However, thrombus formation in the artery and vein of the jejunal graft resulted in a failed reconstruction. Ten days after this surgery, digestive reconstruction using the colon was performed with intraoperative heparin administered for anticoagulation control. The surgery was successful, with no thrombus formation afterward. When performing digestive reconstruction in patients with conditions predisposing to thrombus formation, perioperative management should be completed with careful attention toward preventing thrombus formation. In particular, appropriate anticoagulation control, such as the administration of intraoperative heparin, is recommended in patients with protein C deficiency because necrosis of the reconstructed organ is likely.

Original languageEnglish
Pages (from-to)286-289
Number of pages4
JournalAnnals of Thoracic and Cardiovascular Surgery
Issue number5
Publication statusPublished - 2020


  • Esophagectomy
  • Perioperative management
  • Protein C deficiency
  • Thrombus formation


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