title: Thoracoscopic esophagectomy in the prone position for esophageal cancer with right aortic arch: case report.
abstract: A congenital anomaly of the right aortic arch (RAA) is rare, and esophageal cancer associated with the vascular ring is even more rare. In such cases, it is very important to understand the anatomical situation in the upper mediastinum in order to perform a safe and curative operation. A 52-year-old man who presented with odynophagia was admitted to our department after a diagnosis of advanced esophageal cancer. Chest computed tomography revealed an RAA with an aberrant subclavian artery and showed that the esophagus was completely encircled by the RAA, aortic diverticulum, and pulmonary artery. By the thoracoscopic view with the patient in the prone position, we were able to easily and safely identify the anatomical location of the upper mediastinum and successfully perform thoracoscopic esophagectomy. To the best of our knowledge, this is the first report of a patient undergoing total thoracoscopic esophagectomy in the prone position without thoracotomy.
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. kanashin@med.kobe-u.ac.jp.
authors.forename: Shingo
authors.initials: S
authors.lastname: Kanaji
authors.forename: Tetsu
authors.initials: T
authors.lastname: Nakamura
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Otowa
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Yamashita
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Imanishi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sumi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kakeji
mesh_terms: D001013:Aorta, Thoracic / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016684:Prone Position; D011859:Radiography; D013906:Thoracoscopy / Q000379:methods*; D016896:Treatment Outcome
keywords: Right aortic arch; esophageal cancer; prone position; thoracoscopic esophagectomy