Curative Resection for Thoracic Esophageal Carcinoma with an Aberrant Right Subclavian Artery: A Case Report

Introduction Esophagectomy in the presence of an aberrant right subclavian artery (ARSA) is rare, and the anomalous vascular anatomy can complicate lymphadenectomy because of the risk of nerve injury.Case presentation The patient was a 67-year-old man who presented with pharyngeal discomfort. Right pyriform sinus cancer and middle thoracic esophageal cancer were detected. After neoadjuvant chemotherapy with docetaxel, cisplatin, and 5-fluorouracil for the esophageal cancer, the pyriform sinus cancer disappeared, indicating a complete response. Accordingly, esophagectomy with reconstruction using a gastric conduit was planned, with preservation of the hypopharynx. Because the presence of an ARSA had been recognized preoperatively, cervical lymphadenectomy was first performed via a cervical approach. Esophagectomy was performed thoracoscopically without injury to the nonrecurrent inferior laryngeal nerve (NRILN).Conclusions Esophagectomy in a patient with an ARSA was performed while preserving the NRILN by initiating cervical lymphadenectomy before the thoracoscopic procedure.