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17-11-2023 | Esophagus Resection

Management of esophageal cancer in patients with a right aortic arch or double aortic arch: a case series of 34 cases

Authors: Guoqing Zhang, Zhulin Wang, Jia Jiao, Yipiao Liu, Dabo Pan, Hang Yang, Mengyao Zhan, Fuping Yan, Huijie Li, Yan Zhang, Jindong Li, Xiangnan Li

Published in: Surgical Endoscopy | Issue 1/2024

Abstract

Background

Few cases describing patients with a right aortic arch (RAA) or double aortic arch (DAA) and esophageal cancer (EC) have been reported.

Methods

We analyzed RAA and DAA cases treated with esophagectomy in our center’s database and reported in English-language studies until April 1, 2023. Our study assessed the malformation characteristics and surgical details of EC patients with RAA and DAA.

Results

We extracted data of 24 EC patients with RAAs and 10 EC patients with DAAs. In both groups, the patients were more likely to be Japanese and male, to have squamous cell carcinoma and to have tumors located in the upper thoracic esophagus or middle thoracic esophagus. Left thoracotomy was commonly applied for RAA patients. For DAA patients, the proportions of left-sided and right-sided approaches were similar. Esophagectomy under video-assisted thoracoscopic surgery (VATS) in RAA or DAA patients had been performed on a routine basis in recent years. There were two anastomotic leakages in each group. Specifically, Kommerell diverticulum rupture occurred in 1 RAA patient; gastric tube dilation occurred in 1 DAA patient; and recurrent laryngeal nerve (RLN) injury occurred in 2 RAA patients. The postoperative course was uneventful for most patients in both cohorts.

Conclusions

Esophageal carcinoma is rarely seen in patients with an RAA or DAA. To adequately dissect superior mediastinal LNs, an auxiliary incision (such as sternotomy), the left door open method or a preceding cervical procedure should be used appropriately. Esophagectomy, whether via thoracotomy or thoracoscopic surgery, can be performed safely for both RAA and DAA.

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Title: Management of esophageal cancer in patients with a right aortic arch or double aortic arch: a case series of 34 cases
Authors: Guoqing Zhang
Zhulin Wang
Jia Jiao
Yipiao Liu
Dabo Pan
Hang Yang
Mengyao Zhan
Fuping Yan
Huijie Li
Yan Zhang
Jindong Li
Xiangnan Li
Publication date: 17-11-2023
Publisher: Springer US
Keywords: Esophagus Resection
Esophagus Resection
Esophageal Cancer
Esophageal Cancer
Thoracotomy
Dysphagia
Dysphagia
Dysphagia
Published in: Surgical Endoscopy / Issue 1/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-023-10543-7

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Springer Medicine

Management of esophageal cancer in patients with a right aortic arch or double aortic arch: a case series of 34 cases

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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