title: Esophageal cancer resection associated with a right aortic arch after descending aortic graft replacement.
abstract: Right aortic arch is a rare abnormality. Esophageal cancer associated with a vascular ring is even more rare. We describe a patient with right aortic arch who had previously undergone a graft replacement of descending aorta for aneurysmal rupture followed by subsequent surgery for advanced esophageal cancer. Preoperative three-dimensional computed tomography revealed mirror image branching type right aortic arch and Kommerell's diverticulum of the descending aorta. The patient underwent total esophagectomy with laryngopharyngectomy and regional lymphadenectomy via a left thoracotomy. A permanent tracheal fistula was constructed. Postoperative chemo-radiotherapy was applied. The patient was discharged from hospital and is doing well. Early division of the ligamentum arteriosum with careful management of the aortic diverticulum led to release of the esophagus from the vascular ring that rendered the following procedures safe and afforded a good operative view.
authors: Department of Organ Regenerative Surgery, Ehime University Graduate School of Medicine Shitsukawa, Toon-shi, Ehime 791-0295, Japan. yayuji@m.ehime-u.ac.jp
authors: Yuji
authors: Y
authors: Yamamoto
authors: Yuji
authors: Y
authors: Watanabe
authors: Atsushi
authors: A
authors: Horiuchi
authors: Motohira
authors: M
authors: Yoshida
authors: Hiroki
authors: H
authors: Sugishita
authors: Hiromichi
authors: H
authors: Nakagawa
authors: Shungo
authors: S
authors: Yukumi
authors: Koichi
authors: K
authors: Sato
authors: Kanji
authors: K
authors: Kawachi
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000601:surgery; D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D001015:Aortic Arch Syndromes / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D004945:Esophagoscopy; D006801:Humans; D021621:Imaging, Three-Dimensional; D008207:Lymphatic Metastasis; D008297:Male; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler