Unusual but severe complications following en bloc resection of the oesophagus for cancer

Two uncommon complications of en bloc resection of the oesophagus for cancer are reported: paraplegia, probably related to division of the right intercostal arteries at the thoraco-abdominal junction, and abundant weeping of lymphatic fluid originating from the retropancreatic area due to both the resection of the thoracic duct and a Kocher's manoeuvre that had been performed to facilitate gastric pull-up to the neck. The former strongly suggests that both right and left intercostal arteries should be maintained when performing an en bloc resection of the oesophagus and the latter that Kocher's manoeuvre should be avoided after ligation or resection of the thoracic duct whenever abundant retroperitoneal oedema is present at the time of the laparotomy made for the gastric mobilization.