Postoperative esophageal achalasia after robotic left lower lobectomy for lung cancer: a case report.
- 1Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3 Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan. [email protected].
- 2Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3 Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan.
Abstract
Background
Postoperative esophageal achalasia after lung surgery is extremely rare. Vagal nerve injury has been proposed as a possible mechanism of postsurgical esophageal dysmotility. We report a rare case of esophageal achalasia following robot-assisted lung cancer surgery.Case presentation
A 63-year-old woman with lung adenocarcinoma (cT1cN0M0, stage IA3) underwent robot-assisted left lower lobectomy with systematic mediastinal lymph node dissection. On postoperative day 2, she developed vomiting and difficulty eating. Computed tomography revealed esophageal dilatation with retained food, and esophagography demonstrated absent esophageal peristalsis, narrowing at the esophagogastric junction, and contrast retention. Upper gastrointestinal endoscopy revealed no mechanical obstruction. High-resolution manometry confirmed esophageal achalasia. Pneumatic dilation was performed on postoperative day 15, resulting in improvement of esophagogastric junction relaxation. She was discharged on postoperative day 24 and remained well without recurrence of achalasia 6 years after surgery.Conclusion
Postoperative achalasia is a rare complication of lung surgery. Although the causal mechanism in this case could not be established, perioperative vagal nerve or esophageal plexus injury was considered a possible mechanism. Careful handling of the vagus nerve and cautious use of energy devices near the esophagus may help prevent this complication, and achalasia should be considered in patients with persistent dysphagia after lung surgery.
Related
- Thoracoscopic Esophagectomy for Metachronous Esophageal Cancer after Heller-Dor Surgery for Achalasia with Marked Esophageal Dilatation: A Case Report.
- Postoperative C-Reactive Protein as a Marker of the Early Inflammatory Response in Robotic Versus Laparoscopic Minimally Invasive Surgery for Endometrial Cancer: A Propensity Score-Matched Analysis
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- Reflux and Other Esophageal Acidification Patterns in Achalasia Patients With Reflux Esophagitis After Peroral Endoscopic Myotomy
- Long-term outcomes after treatment of esophageal achalasia: a single-center retrospective study of laparoscopic Heller myotomy with partial fundoplication vs pneumatic dilation
BibTeX
@article{watanabe2026postoperative,
title = {{Postoperative esophageal achalasia after robotic left lower lobectomy for lung cancer: a case report.}},
author = {Yukio Watanabe and Mariko Fukui and Aritoshi Hattori and Takeshi Matsunaga and Kazuya Takamochi and Kenji Suzuki},
journal = {General thoracic and cardiovascular surgery cases},
year = {2026},
month = oct,
doi = {10.1186/s44215-026-00285-y},
url = {https://europepmc.org/article/MED/42920186},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Postoperative esophageal achalasia after robotic left lower lobectomy for lung cancer: a case report.
AU - Yukio Watanabe
AU - Mariko Fukui
AU - Aritoshi Hattori
AU - Takeshi Matsunaga
AU - Kazuya Takamochi
AU - Kenji Suzuki
PY - 2026
DA - 2026/10/23
JO - General thoracic and cardiovascular surgery cases
DO - 10.1186/s44215-026-00285-y
UR - https://europepmc.org/article/MED/42920186
AB - Background Postoperative esophageal achalasia after lung surgery is extremely rare. Vagal nerve injury has been proposed as a possible mechanism of postsurgical esophageal dysmotility. We report a rare case of esophageal achalasia following robot-assisted lung cancer surgery.Case presentation A 63-year-old woman with lung adenocarcinoma (cT1cN0M0, stage IA3) underwent robot-assisted left lower lobectomy with systematic mediastinal lymph node dissection. On postoperative day 2, she developed vomiting and difficulty eating. Computed tomography revealed esophageal dilatation with retained food, and esophagography demonstrated absent esophageal peristalsis, narrowing at the esophagogastric junction, and contrast retention. Upper gastrointestinal endoscopy revealed no mechanical obstruction. High-resolution manometry confirmed esophageal achalasia. Pneumatic dilation was performed on postoperative day 15, resulting in improvement of esophagogastric junction relaxation. She was discharged on postoperative day 24 and remained well without recurrence of achalasia 6 years after surgery.Conclusion Postoperative achalasia is a rare complication of lung surgery. Although the causal mechanism in this case could not be established, perioperative vagal nerve or esophageal plexus injury was considered a possible mechanism. Careful handling of the vagus nerve and cautious use of energy devices near the esophagus may help prevent this complication, and achalasia should be considered in patients with persistent dysphagia after lung surgery.
SN - 2731-6203
ER -