Zheng Yu, Zhao Xi-Wen, Zhang Han-Lu, Wang Zi-Hao, Wang Yun
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
West China College of Stomatology, Sichuan University, Chengdu 610041, China.
J Thorac Dis. 2018 Feb;10(2):E113-E115. doi: 10.21037/jtd.2017.12.105.
The present study is the first reported case of a patient undergoing esophagectomy with ectopic aortic arch secondary to a large esophageal cancer, which was pre-operatively misdiagnosed with a right-side aortic arch (RAA). The patient, a 54-year-old male, was first admitted to our hospital for esophagectomy owing to esophageal squamous cancer and had complained of progressive dysphasia for 3 months. Chest computed tomography (CT) revealed a mass in the middle thoracic esophagus. Furthermore, the three-dimensional CT of the thoracic great arteries showed a possible RAA and a curved descending aorta. After preoperative evaluation, the approach of using a left thoracotomy with cervical anastomosis was successfully performed and favorable short-term outcomes were achieved. According to previous reports, and the experience of the presented case, we emphasize clear recognition of the anatomical situation in the upper mediastinum and the importance of an optimal surgical approach for esophagectomy.
本研究首次报道了一例因巨大食管癌接受食管切除术的患者,该患者术前被误诊为右侧主动脉弓(RAA),实际为异位主动脉弓。患者为54岁男性,因食管鳞状癌首次入住我院接受食管切除术,主诉进行性吞咽困难3个月。胸部计算机断层扫描(CT)显示胸段食管中段有一肿块。此外,胸部大动脉的三维CT显示可能为RAA及降主动脉迂曲。经过术前评估,成功实施了左胸切开术并进行颈部吻合,取得了良好的短期效果。根据既往报道及本病例经验,我们强调对上纵隔解剖情况的清晰认识以及食管切除术最佳手术入路的重要性。