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Three-hole oesophagectomy following bilateral lung transplant for cystic fibrosis
  1. Roy Avraham Hilzenrat1 and
  2. John Yee2
  1. 1Surgery, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
  2. 2Thoracic Surgery, Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Roy Avraham Hilzenrat; roy.hilzenrat{at}


Cystic fibrosis (CF) is associated with increased rates of malignancy, particularly in lung transplant recipients requiring long-term immunosuppression. We present a unique case of post-bilateral lung transplant (LTx) three-hole oesophagectomy for de-novo oesophageal adenocarcinoma. Preoperative planning and careful fluid management allowed for a successful treatment course. Given the increased risk of de-novo malignancy in LTx recipients for CF, their improved quality of life and survival longevity, consideration of aggressive surgical management is imperative with appropriate patient selection.

  • oesophageal cancer
  • cardiothoracic surgery
  • surgical oncology
  • transplantation

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  • Contributors JY was the treating physician for this patient and had made the primary clinical and surgical decisions described in the manuscript. In deciding to pursue the surgical technique, JY had reviewed prior literature on similar cases, of which there was very little. JY helped formulate the main concepts discussed in the manuscript and edited the final draft. RH conducted the preliminary literature review prior to the commencement of this case report and wrote the first manuscript draft. He also revised the draft following BMJ editor review. JY and RH had worked cooperatively both on the surgical case and patient care and the development of this case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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