Diagnosis and surgical treatment of esophageal carcinoma with coexistent intrathoracic vascular malformations

Thoracic Cancer
Zhong-Xi NiuLong-Qi Chen

Abstract

The anomaly of intrathoracic large vessels might not only compress the esophagus resulting in dysphagia, but also hinder esophagectomy, even leading to uncontrolled massive hemorrhaging. This paper reviews our experience of seven patients with this diagnosis and their treatment. From January 2007 through January 2012, among patients admitted with esophageal carcinoma, there were seven patients confirmed to have coexisted intrathoracic vascular anomalies. They were six men and one woman, aged 52 to 63 (mean 58.42). The vascular anomalies included aberrant right subclavian artery (ARSA) in three cases, post-aortic left innominate vein (PALIV) in two cases, and one case each of right aortic arch (RAA) and pseudoaneurysm of aortic isthmus (PAAI). Their diagnosis, surgical strategy, and outcome were reviewed. The vascular anomalies were missed by esophagography and endoscopy, but all identified by enhanced chest computed tomography (CT). Surgery was planned according to the anatomic features of the anomalies. ARSA did not need special management. RAA underwent left thoracotomy in order to dissect the aortopulmonary arterial ligament and to facilitate the mobilization of the esophagus. PAAI had preoperative aortic stenting to prevent...Continue Reading

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Citations

Apr 12, 2016·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·H-L WuJ-Q Guo
Dec 19, 2018·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Vignesh ShanmugamOry Wiesel

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