Preoperative evaluation of right superior pulmonary vein anomaly for safe thoracoscopic esophagectomy Haruka OKADA 1 , Hiroaki HATA 1 , Ryo MATSUSUE 1 , Takashi YAMAGUCHI 1 , Tetsushi OHTANI 1 , Iwao IKAI 1 1Department of Surgery, National Hospital Organization Kyoto Medical Center Keyword: 肺静脈 , 走行異常 , 食道癌 pp.87-93
Published Date 2020/3/15
DOI https://doi.org/10.11477/mf.4426200781
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 An anatomical variation of the right superior pulmonary vein passing behind the right main bronchus or bronchus intermedius is rare. This anomalous vein drains directly into the left atrium or pulmonary veins, and has been discussed mainly by thoracic surgeons and cardiologists previously. We report two surgical cases of esophageal cancer with the rare anomalous pulmonary veins which were identified preoperatively. In one case, the anomalous vein passed behind the right main bronchus and we performed subcarinal lymph node dissection dividing the area into a central and a peripheral part of the vein. In the other case, the anomalous vein ran behind the bronchus intermedius located peripherally in the mediastinum and was less interfering during lymph node dissection. We preserved those anomalous veins in both cases. The influence of the anomalous veins to subcarinal lymph node dissection for esophageal cancer differs depending on the route of the vein in the mediastinum. Careful evaluation of preoperative computed tomographic images is essential to identify those variant veins for a safe subcarinal lymph node dissection for esophageal cancer.

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