先天性咽下困难：胸外手术治疗
Dysphagia lusoria: extrathoracic surgical management.
作者信息
Taylor M, Harris K A, Casson A G, DeRose G, Jamieson W G
机构信息
Department of Surgery, Victoria Hospital, University of Western Ontario, London, Ont.
出版信息
Can J Surg. 1996 Feb;39(1):48-52.
OBJECTIVE
To report a case of dysphagia lusoria managed by an extrathoracic approach.
DESIGN
Case report and literature review.
SETTING
A university hospital.
PATIENT
A 39-year-old man, who presented with weight loss and dysphagia. Aortography and computed tomography revealed an aberrant subclavian artery compressing the esophagus against the aortic arch.
INTERVENTION
The right subclavian artery was divided at its origin and reimplanted onto the right carotid artery. The operation was performed through a right supraclavicular incision without opening the chest.
RESULTS
There was no operative morbidity. Six months postoperatively the patient was asymptomatic and had gained weight. There was no radiologic evidence of esophageal compression.
CONCLUSIONS
Based on the results of our case of dysphagia lusoria and the reports of others that have started to appear in the literature, consideration should be given to repairing a symptomatic, nonaneurysmal aberrant right subclavian artery through an extrathoracic approach.
目的
报告1例采用胸外入路治疗的迷走性吞咽困难病例。
设计
病例报告及文献复习。
单位
一所大学医院。
患者
一名39岁男性，出现体重减轻和吞咽困难症状。主动脉造影和计算机断层扫描显示，异常锁骨下动脉将食管压向主动脉弓。
干预措施
在右锁骨下动脉起始处将其离断，并重新移植至右颈动脉。手术通过右锁骨上切口进行，未打开胸腔。
结果
无手术相关并发症。术后6个月，患者无症状且体重增加。影像学检查未发现食管受压迹象。
结论
基于我们这例迷走性吞咽困难病例的结果以及文献中开始出现的其他报道，对于有症状的非动脉瘤性异常右锁骨下动脉，应考虑采用胸外入路进行修复。
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