Mahmodlou Rahim, Sepehrvand Nariman, Hatami Sanaz
Department of Surgery, Urmia University of Medical Sciences, Urmia, Iran.
Department of Students' Research Committee, Urmia University of Medical Sciences, Urmia, Iran.
J Surg Tech Case Rep. 2014 Jul-Dec;6(2):61-3. doi: 10.4103/2006-8808.147262.
Aberrant right subclavian artery (ARSA) is a rare anomaly, in which the right subclavian artery arises directly from the aortic arch instead of originating from the brachiocephalic artery. This anomaly should be taken into consideration during surgical procedures around esophagus, such as esophagectomy. Any unintentional injury of this artery during surgical procedures could be extremely life threatening. A 56-year-old woman presented with dysphagia, with concurrent aberrant subclavian artery and esophageal cancer. The transhiatal esophagectomy was performed successfully since the anomaly was preoperatively diagnosed using computed tomography scan. The presence of ARSA during esophagectomy may be challenging, but if diagnosed preoperatively, the precise and diligent dissection of the retroesophageal space during esophagectomy, may prevent any injury to the aberrant artery and consequent complications.
迷走右锁骨下动脉(ARSA)是一种罕见的异常情况,即右锁骨下动脉直接发自主动脉弓,而非起自头臂动脉。在食管周围的外科手术,如食管切除术过程中,应考虑到这种异常情况。手术过程中对该动脉的任何意外损伤都可能极其危及生命。一名56岁女性因吞咽困难就诊,同时患有迷走右锁骨下动脉和食管癌。由于术前通过计算机断层扫描诊断出了这种异常情况,经胸食管切除术得以成功进行。食管切除术中存在ARSA可能具有挑战性,但如果术前诊断明确,在食管切除术中对食管后间隙进行精确、细致的解剖,可能会避免对迷走动脉的任何损伤及随之而来的并发症。