Abstract:
BACKGROUND:Esophageal cancer frequently metastasizes to lymph nodes along the recurrent laryngeal nerve (RLN),1 therefore it is essential to dissect RLN nodes for curative esophagectomy.2 Right-sided aortic arch (RAA), a rare congenital anomaly, occurs in approximately 0.1% of adults.3 Because RAA forms a vascular ring encircling both the esophagus and the trachea at the cervicothoracic junction, its surgical anatomy is difficult to understand; hence, thoracoscopic dissection of RLN nodes is technically challenging. In this video, we applied the cervicothoracoscopic approach in a patient with esophageal squamous cell carcinoma and RAA, wherein the cervical operation was performed prior to the thoracoscopic operation.4 METHODS: A 60-year-old woman was diagnosed with stage IA esophageal squamous cell carcinoma. During preoperative evaluation, we found that she had RAA with an aberrant left subclavian artery, and therefore decided to perform esophagectomy using the cervicothoracoscopic approach. In the cervical operation, we identified the RLN and dissected the lymph node in the cervicothoracic junction. The thoracoscopic operation was then performed from the left side with the patient in the prone position. RESULTS:The operation was successful. Total operative time was 548 min, with an estimated blood loss of 220 ml. There were no intraoperative and postoperative complications, and RLN palsy did not occur. CONCLUSIONS:The vascular ring at the cervicothoracic junction in a patient with RAA made it difficult to dissect the RLN lymph nodes during oncologic esophagectomy. The cervicothoracoscopic approach enables the complete dissection of these lymph nodes and is a useful esophagectomy technique for patients with RAA.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Okamura A,Watanabe M,Yuda M,Shoji Y,Yamashita K,Hayami M,Imamura Y,Mine Sdoi
10.1245/s10434-018-6355-3subject
Has Abstractpub_date
2018-05-01 00:00:00pages
1287issue
5eissn
1068-9265issn
1534-4681pii
10.1245/s10434-018-6355-3journal_volume
25pub_type
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journal_title:Annals of surgical oncology
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,随机对照试验
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journal_title:Annals of surgical oncology
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journal_title:Annals of surgical oncology
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2008-08-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2006-12-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
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更新日期:1998-01-01 00:00:00
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,多中心研究
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2000-04-01 00:00:00