title: Esophagectomy with three-field lymph node dissection for esophageal carcinoma with a nonrecurrent inferior laryngeal nerve.
abstract: In rare cases, the inferior laryngeal nerve branches directly from the vagus trunk. A 58-year-old man with carcinoma of the thoracic esophagus was referred to our hospital. A nonrecurrent anomaly of the right recurrent laryngeal nerve associated with an aberrant right subclavian artery was detected preoperatively by computed tomography and magnetic resonance imaging. This artery ran on the right side between the esophagus and the vertebral column. Recognition of this nerve before upper mediastinal lymph node dissection was thought to be important for avoiding unexpected neural injuries. For a successful esophagectomy with three-field lymph node dissection in patients associated with this anomaly, a cervico-abdominal procedure followed by a thoracic procedure, which is the reverse of the usual process, could be useful for a safe operation. However, this anomaly made it difficult to dissect lymph node along the left recurrent laryngeal nerve.
authors.affiliation: Department of Esophageal Surgery, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sato
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsubosa
authors.forename: Toru
authors.initials: T
authors.lastname: Ugumori
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012009:Recurrent Laryngeal Nerve / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D013348:Subclavian Artery / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed