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使用胸腔镜手术成功切除伴有异常右锁骨下动脉的食管癌:两例报告。

Successful resection of esophageal carcinoma with aberrant right subclavian artery using video-assisted thoracoscopic surgery: report of two cases.

机构信息

Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, 545-8585, Osaka Japan.

出版信息

Anticancer Res. 2014 Feb;34(2):899-904.

Abstract

The right non-recurrent inferior laryngeal nerve (NRILN) is a rare nerve anomaly that communicates the laryngeal nerve to the right vagal nerve trunk directly in the neck, which is usually accompanied by aberrant right subclavian artery (ARSA). We report on two cases of thoracic esophageal carcinoma undertaken in patients with these abnormalities: a 73-year-old woman with progressive dysphagia and a 63-year-old asymptomatic man. Although there have been 10 cases of thoracic esophageal carcinomas associated with ARSA and NRILN in literature, as far as we are aware of, this is the first report to describe successful resection using video-assisted thoracoscopic surgery (VATS). We found that the combination of preoperative recognition of the ARSA using three-dimensional computed tomography (3D-CT) and VATS in the prone position allowed for visual magnification with an excellent thoracoscopic view and facilitated successful tumor resection and preservation of NRILN.

摘要

右侧非返性喉下神经(NRILN)是一种罕见的神经异常,它直接在颈部将喉返神经与右侧迷走神经干沟通,通常伴有异常右锁骨下动脉(ARSA)。我们报告了两例伴有这些异常的胸段食管癌患者:一名 73 岁的进行性吞咽困难女性和一名 63 岁的无症状男性。尽管文献中有 10 例胸段食管癌与 ARSA 和 NRILN 相关,但据我们所知,这是首例描述使用电视辅助胸腔镜手术(VATS)成功切除的报告。我们发现,术前使用三维计算机断层扫描(3D-CT)识别 ARSA,并在俯卧位下使用 VATS,可实现视觉放大,具有极佳的胸腔镜视野,并有助于成功切除肿瘤和保留 NRILN。

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