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伴有异常锁骨下动脉的食管癌的颈部淋巴结清扫术和胸腔镜下食管癌切除术

Neck Dissection and Thoracoscopic Esophagectomy in Esophageal Cancer with Aberrant Subclavian Artery.

作者信息

Kitagawa Hiroyuki, Namikawa Tsutomu, Hanazaki Kazuhiro

机构信息

Department of Surgery, Kochi Medical School, Nankoku, Japan.

Department of Surgery, Kochi Medical School, Nankoku, Japan

出版信息

Anticancer Res. 2017 Jul;37(7):3787-3790. doi: 10.21873/anticanres.11754.

Abstract

We report a case of esophageal cancer with a non-recurrent inferior laryngeal nerve associated with aberrant right subclavian artery treated with neck dissection followed by thoracoscopic esophagectomy. A 60-year-old man experienced esophageal cancer, hoarseness, and left supraclavicular lymph node swelling was noted on endoscopy. Computed tomography revealed an aberrant right subclavian artery between the esophagus and vertebrae. We administered neo-adjuvant chemotherapy and performed thoracoscopic esophagectomy. During the neck dissection, we confirmed a non-recurrent inferior laryngeal nerve along the inferior thyroid artery. After the neck dissection, we performed thoracoscopic esophagectomy. We confirmed an aberrant right subclavian artery arising from the aortic arch, and resected the left recurrent nerve due to cancer invasion. No postoperative complication was observed, and the patient was discharged 17 days after surgery. Thus, we recommend prior neck dissection in cases involving aberrant right subclavian artery during esophagectomy.

摘要

我们报告一例食管癌患者,其喉返神经未出现异常,但伴有迷走右锁骨下动脉,该患者接受了颈部清扫术,随后进行了胸腔镜食管切除术。一名60岁男性患有食管癌,出现声音嘶哑,内镜检查发现左锁骨上淋巴结肿大。计算机断层扫描显示食管与椎体之间存在迷走右锁骨下动脉。我们给予新辅助化疗并进行了胸腔镜食管切除术。在颈部清扫术中,我们沿甲状腺下动脉确认了一条非返行性喉返神经。颈部清扫术后,我们进行了胸腔镜食管切除术。我们确认一条迷走右锁骨下动脉发自主动脉弓,并因癌症侵犯切除了左侧喉返神经。术后未观察到并发症,患者术后17天出院。因此,我们建议在食管切除术中涉及迷走右锁骨下动脉的病例中先行颈部清扫术。

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