Diagnosis and surgical treatment of @entity418 with XXXX .

@entity1 @entity455 @entity548 @entity1755 @entity1462 @entity418 @entity1282 @entity2849 @entity5216
BACKGROUND: The anomaly of intrathoracic large vessels might not only compress the esophagus resulting in @entity1282 , but also hinder esophagectomy, even leading to uncontrolled massive @entity548 . This paper reviews our experience of seven @entity1 with this diagnosis and their treatment. METHODS: From January 2007 through January 2012, among @entity1 admitted with @entity418 , there were seven @entity1 confirmed to have coexisted @entity455 . They were six @entity1 and one @entity1 , aged 52 to 63 (mean 58.42). The @entity455 included @entity5216 ( @entity5216 ) in three cases, post-aortic left innominate vein (PALIV) in two cases, and one case each of right aortic arch (RAA) and @entity2849 of aortic isthmus (PAAI). Their diagnosis, surgical strategy, and outcome were reviewed. RESULTS: The @entity455 were missed by esophagography and endoscopy, but all identified by enhanced chest computed tomography (CT). Surgery was planned according to the anatomic features of the anomalies. @entity5216 did not need special management. RAA underwent left thoracotomy in order to dissect the aortopulmonary arterial ligament and to facilitate the mobilization of the esophagus. PAAI had preoperative aortic stenting to prevent unexpected @entity1755 . Prophylactic ligation of thoracic duct was performed on all @entity1 and no postoperative chylothorax was documented. CONCLUSIONS: The coexistence of @entity1462 with @entity418 is rare, but easily missed in routine X-ray and endoscopy. Enhanced chest CT must be performed to confirm. Surgery should be designed individually in consideration of the anatomic features of the @entity455 . A routine prophylactic ligation of the thoracic duct is recommended.
