Surgical case reports · 2026
Curative Resection for Thoracic Esophageal Carcinoma with an Aberrant Right Subclavian Artery: A Case Report.
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Nishida Nobuyuki, Takeno Shinsuke, Ikenoue Makoto, Munakata Shun, Chiyotanda Teru, Kawano Fumiaki, Ichihara Akiko, Yamada Kazunosuke, Hamada Roko, Hara Daisuke, Iwamoto Kazuki, Nakame Kazuhiko, Matsukubo Makoto, Nanashima Atsushi
Аннотация
INTRODUCTION: Esophagectomy in the presence of an aberrant right subclavian artery (ARSA) is rare, and the anomalous vascular anatomy can complicate lymphadenectomy because of the risk of nerve injury.
CASE PRESENTATION: The patient was a 67-year-old man who presented with pharyngeal discomfort. Right pyriform sinus cancer and middle thoracic esophageal cancer were detected. After neoadjuvant chemotherapy with docetaxel, cisplatin, and 5-fluorouracil for the esophageal cancer, the pyriform sinus cancer disappeared, indicating a complete response. Accordingly, esophagectomy with reconstruction using a gastric conduit was planned, with preservation of the hypopharynx. Because the presence of an ARSA had been recognized preoperatively, cervical lymphadenectomy was first performed via a cervical approach. Esophagectomy was performed thoracoscopically without injury to the nonrecurrent inferior laryngeal nerve (NRILN).
CONCLUSIONS: Esophagectomy in a patient with an ARSA was performed while preserving the NRILN by initiating cervical lymphadenectomy before the thoracoscopic procedure.
CASE PRESENTATION: The patient was a 67-year-old man who presented with pharyngeal discomfort. Right pyriform sinus cancer and middle thoracic esophageal cancer were detected. After neoadjuvant chemotherapy with docetaxel, cisplatin, and 5-fluorouracil for the esophageal cancer, the pyriform sinus cancer disappeared, indicating a complete response. Accordingly, esophagectomy with reconstruction using a gastric conduit was planned, with preservation of the hypopharynx. Because the presence of an ARSA had been recognized preoperatively, cervical lymphadenectomy was first performed via a cervical approach. Esophagectomy was performed thoracoscopically without injury to the nonrecurrent inferior laryngeal nerve (NRILN).
CONCLUSIONS: Esophagectomy in a patient with an ARSA was performed while preserving the NRILN by initiating cervical lymphadenectomy before the thoracoscopic procedure.