title: Salvage lymphadenectomy of the right recurrent nerve node with tracheal involvement after definitive chemoradiation therapy for esophageal squamous cell carcinoma: report of two cases.
abstract: Thoracic esophageal cancers frequently metastasize to the right recurrent nerve nodes (RRNNs). In fact, huge RRNNs invading the trachea sometimes remain after definitive chemoradiation therapy (CRT), despite complete remission of the primary lesion. We performed salvage lymphadenectomy of a large RRNN combined with partial resection of the trachea in two patients. Using an anterior approach, we removed part of the sternum, clavicle, and the first and second costal cartilage; then, we removed the RRNNs with combined resection of the lateral quarter circumference of the trachea, the esophageal wall, and the recurrent nerve. Reconstruction was done with a musculocutaneous patch of major pectoral muscle to cover the tracheal defect. The only minor complication was venous thrombosis in one patient. Thus, combined removal of the RRNN and trachea was performed safely as a salvage operation after definitive CRT for esophageal squamous cell carcinoma.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Takushi
authors.initials: T
authors.lastname: Yasuda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyata
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Shuji
authors.initials: S
authors.lastname: Takiguchi
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Makari
authors.forename: Jin
authors.initials: J
authors.lastname: Matsuyama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Masuoka
authors.forename: Morito
authors.initials: M
authors.lastname: Monden
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D016629:Esophagectomy; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007275:Injections, Intravenous; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010524:Peripheral Nervous System Neoplasms / Q000556:secondary* / Q000601:surgery; D012009:Recurrent Laryngeal Nerve; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D014134:Tracheal Neoplasms / Q000556:secondary* / Q000601:surgery
chemical_list: D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D002945:Cisplatin; D005472:Fluorouracil