Thoracoscopic Oesophagectomy Using Prone Positioning for Oesophageal Cancer With Right Aortic Arch: A Case Report

Anticancer Res. 2019 Jun;39(6):3207-3211. doi: 10.21873/anticanres.13460.

Abstract

Background/aim: Right aortic arch (RAA) is a rare abnormality of the aortic arch that forms a vascular ring. Oesophageal cancer (EC) accompanied with RAA is even rarer, and in such cases, it is very important to understand the anatomical structure in the upper mediastinum in order to perform a safe and curative operation.

Patients and methods: A 67-year-old man who presented with pharyngeal discomfort was admitted to our hospital. Further examinations revealed advanced thoracic EC accompanied with RAA and aortic diverticulum.

Results: After neoadjuvant chemotherapy, we successfully and safely performed thoracoscopic oesophagectomy and lymphadenectomy using the prone positioning.

Conclusion: There exist only a few reports of thoracoscopic oesophagectomy for EC with RAA. Sufficient preoperative preparation and sharing an adequate strategy for the surgical approach with the surgical team are definitely necessary. Although the thoracoscopic approach for EC with RAA is useful, more considerations are needed for some issues.

Keywords: Oesophageal cancer; prone position; right aortic arch; surgery; thoracoscopic.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aorta, Thoracic / abnormalities*
  • Aorta, Thoracic / diagnostic imaging
  • Aortography / methods
  • Chemotherapy, Adjuvant
  • Computed Tomography Angiography
  • Esophageal Neoplasms / diagnostic imaging
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / methods*
  • Humans
  • Lymph Node Excision
  • Male
  • Neoadjuvant Therapy
  • Patient Positioning / methods*
  • Prone Position*
  • Thoracoscopy*
  • Treatment Outcome