Aberrant subclavian artery causing difficulty in transhiatal esophageal dissection.
ABSTRACT The right subclavian artery normally arises from the brachiocephalic artery. Anomalies in development may lead to peculiar problems during surgery. We report a patient with esophageal carcinoma who had an aberrant right subclavian artery, posing specific difficulties during a transhiatal esophagectomy, requiring conversion of the procedure into a transthoracic approach. The embryologic basis of this anomaly and the clinical significance are discussed.
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ABSTRACT: It is necessary to dissect recurrent nerve lymph nodes to improve the surgical prognosis of patients with esophageal cancer 1 , so the anatomy of bilateral recurrent nerves must be identified during the operation. In rare cases a recurrent nerve is non-recurrent, branching directly from the vagus trunk 2 . This anomaly of a right non-recurrent recurrent nerve is closely associated with an aberrant right subclavian artery 3,4 , which can be recognized on enhanced computed tomography. We present a rare case of esophageal cancer with an aberrant right subclavian artery. SUMMARY We report a rare case of esophageal carcinoma accompanied by an aberrant right subclavian artery. Esophagectomy was performed on a 74-year-old man with esophageal cancer and a right retroesophageal subclavian artery was found during the operation. This brought some anatomical problems: a right recurrent nerve could not be identified when right paratracheal lymph nodes in the mediastinum were dissected. It is important for the operation to dissect recurrent nerve lymph nodes, so computed tomography CT must be examined in detail preoperatively because a right inferior laryngeal nerve is not recurrent if a right subclavian artery arises from the posterior wall of the aortic arch as its last branch and runs rightwards and upwards between the esophagus and the vertebra.01/2008;
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ABSTRACT: We report a case of carcinoma of the hypopharynx and cervical esophagus in a patient with an aberrant right subclavian artery. Barium esophagography, endoscopy, and computed tomography showed a resectable tumor in the hypopharynx and cervical esophagus, coexistent with an aberrant right subclavian artery. We performed pharyngolaryngoesophagectomy with bilateral neck dissection and gastric pull-up through cervical, right thoracic, and abdominal incisions. We also partially resected the aberrant right subclavian artery with reimplantation in the right common carotid artery. To our knowledge, this is the first report of pharyngolaryngoesophagectomy with transposition of an aberrant right subclavian artery.Surgery Today 08/2011; 41(8):1112-6. · 0.96 Impact Factor
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ABSTRACT: When performing video-assisted thoracoscopic esophagectomy, the area at the level above the aortic and in the space between the esophagus and the spine, is usually regarded as a safe area for dissection of upper segment of thoracic esophagus. However, an aberrant right subclavian artery may appear in this area and lead to disastrous complications. We reported a case of aberrant artery encountered during video-assisted thoracoscopic esophagectomy. In order to avoid iatrogenic damage to this artery, it was converted to thoracotomy.Journal of thoracic disease. 08/2013; 5(4):E137-9.