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01-03-2018 | Original Article

Spatial relationships of the bronchial arteries to the left recurrent laryngeal nerve in the sub-aortic arch area

Authors: Ken Hayasaka, Hajime Ishida, Ryosuke Kimura, Tadashi Nishimaki

Published in: Surgery Today | Issue 3/2018

Abstract

Purpose

To safely perform lymphadenectomy in the sub-aortic arch area during esophagectomy for esophageal cancer, we investigated the spatial relationships between the bronchial arteries (BAs) and the left recurrent laryngeal nerve (LRLN).

Methods

For this macro-anatomical study, 72 cadavers were used.

Results

Of the 195 dissected BAs, 15 (7.7%) arteries ran dorsally across the LRLN. Such a running pattern of the BA was found in 15 (20.8%) of the 72 cadavers. Fourteen (93.3%) of the 15 arteries ran anteriorly along the left side of the esophagus, and 13 (86.7%) passed further to the lateral side of the left main bronchus to reach the ventral surface of the tracheobronchus; we named this running pattern “Type III”. Of the 51 arteries with the Type III pattern, 25.5% ran across the dorsal side of the LRLN.

Conclusion

Approximately 20% of the cadavers had BAs running dorsally to the LRLN in the sub-aortic arch area. Most of these arteries had the Type III pattern. One-quarter of the BAs with the Type III pattern showed this running pattern. Care must be practiced to safely perform lymphadenectomy for esophageal cancer in patients with Type III BAs.

Nishimaki T, Suzuki T, Kanda T, Obinata I, Komukai S, Hatakeyama K. Extended radical esophagectomy for superficially invasive carcinoma of the esophagus. Surgery. 1999;125:142–7.CrossRefPubMed

Kanemura T, Makino T, Miyazaki Y, Takahashi T, Kurokawa Y, Yamasaki M, et al. Distribution patterns of metastases in recurrent laryngeal nerve lymph nodes in patients with squamous cell esophageal cancer. Dis Esophagus. 2017;30:1–7.PubMed

D’journo X-B, Michelet P, Avaro J-P, Trousse D, Giudicelli R, Fuentes P, et al. Respiratory complications after oesophagectomy for cancer. Rev Mal Respir. 2008;25:683–94.CrossRefPubMed

Maruyama K, Motoyama S, Sato Y, Hayashi K, Usami S, Minamiya Y, et al. Tracheobronchial lesions following esophagectomy: erosions, ulcers, and fistulae, and the predictive value of lymph node-related factors. World J Surg. 2009;33:778–84.CrossRefPubMed

Bartels HE, Stein HJ, Siewert JR. Tracheobronchial lesions following oesophagectomy: prevalence, predisposing factors and outcome. Br J Surg. 1998;85:403–6.CrossRefPubMed

Taniyama Y, Miyata G, Kamei T, Nakano T, Abe S, Katsura K, et al. Complications following recurrent laryngeal nerve lymph node dissection in oesophageal cancer surgery. Interact Cardiovasc Thorac Surg. 2015;20:41–6.CrossRefPubMed

Hayasaka K, Ishida H, Kimura R, Nishimaki T. A new anatomical classification of the bronchial arteries based on the spatial relationships to the esophagus and the tracheobronchus. Surg Today. 2017;47:883–90.CrossRefPubMed

Eid N, Otsuki Y. Anomalous bronchial arteries with surgically important relationships to abnormal recurrent laryngeal nerve and thoracic duct. Clin Anat. 2010;23:897–8.CrossRefPubMed

Kasai T, Chiba S. Macroscopic anatomy of the bronchial arteries. Anat Anz. 1979;145:166–81.PubMed

10.

Boyden EA. The developing bronchial arteries in a fetus of the twelfth week. Am J Anat. 1970;129:357–68.CrossRefPubMed

11.

Boyden EA. The time lag in the development of bronchial arteries. Anat Rec. 1970;166:611–4.CrossRefPubMed

12.

O’Rahilly R, Boyden EA. The timing and sequence of events in the development of the human respiratory system during the embryonic period proper. Z Anat Entwicklungsgesch. 1973;141:237–50.CrossRefPubMed

13.

Steinberg JL, Khane GJ, Fernandes CM, Nel JP. Anatomy of the recurrent laryngeal nerve: a redescription. J Laryngol Otol. 1986;100:919–27.CrossRefPubMed

14.

Licata RH. The human embryonic heart in the ninth week. Am J Anat. 1954;94:73–125.CrossRefPubMed

15.

Rana MS, Sizarov A, Christoffels VM, Moorman AFM. Development of the human aortic arch system captured in an interactive three-dimensional reference model. Am J Med Genet Part A. 2014;164:1372–83.CrossRef

16.

Fujita H, Kawahara H, Hidaka M, Nagano T, Yoshimatsu H. An experimental study on viability of the devascularized trachea. Jpn J Surg. 1988;18:77–83.CrossRefPubMed

17.

Fujita H, Hawahara H, Yamana H, Shirohazu G, Yoshimura Y, Minami T, et al. Mediastinal lymphnode dissection procedure during esophageal cancer operation-carefully considered for preserving respiratory function. Jpn J Surg. 1988;18:31–4.CrossRefPubMed

18.

Morita Y, Takase K, Ichikawa H, Yamada T, Sato A, Higano S, et al. Bronchial artery anatomy: preoperative 3D simulation with multidetector CT. Radiology. 2010;255:934–43.CrossRefPubMed

19.

Wada T, Takeuchi H, Kawakubo H, Nakamura R, Oyama T, Takahashi T, et al. Clinical utility of preoperative evaluation of bronchial arteries by three-dimensional computed tomographic angiography for esophageal cancer surgery. Dis Esophagus. 2013;26:616–22.CrossRefPubMed

Title: Spatial relationships of the bronchial arteries to the left recurrent laryngeal nerve in the sub-aortic arch area
Authors: Ken Hayasaka
Hajime Ishida
Ryosuke Kimura
Tadashi Nishimaki
Publication date: 01-03-2018
Publisher: Springer Singapore
Published in: Surgery Today / Issue 3/2018
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-017-1593-8

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Springer Medicine

Spatial relationships of the bronchial arteries to the left recurrent laryngeal nerve in the sub-aortic arch area

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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