Surgical approach with minimally invasive intervention in lusoria dysphagia.

Carlos Alcántara-Noguez, Desireé Leines-Castelán, Aarón E Buenabad-Hernández, Alejandra Contreras-Ramos, Sergio Ruiz-González, Patricia Romero-Cardenas, Alejandro Bolio-Cerdan
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Abstract

The lusoria artery has a prevalence of 0.5-2% in the general population. The abnormal development of the aortic arch forms vascular rings around the trachea and esophagus, causing pressure on them and leading to characteristic symptoms such as chest pain, difficulty breathing, and/or swallowing. Conventionally, only the subclavian artery was severed to release the esophagus, as done in neonates. However, this can lead to long-term hypotrophy of the thoracic limb. The surgical intervention remains controversial, with limitations, and it is only to be performed when the patient presents with symptoms. In the following two cases, a two-stage minimally invasive approach is described: first, a left lateral minithoracotomy for lusoria artery sectioning, and second, a supraclavicular approach for reimplantation into the right carotid artery.

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微创手术治疗吞咽困难。
在普通人群中,主动脉瘤的发病率为 0.5%-2%。主动脉弓的异常发育会在气管和食管周围形成血管环,对其造成压力,导致胸痛、呼吸困难和/或吞咽困难等特征性症状。传统的做法是只切断锁骨下动脉来释放食管,新生儿也是如此。然而,这会导致胸廓肢体长期萎缩。手术干预仍存在争议和局限性,只有在患者出现症状时才能进行。在以下两个病例中,描述了一种分两个阶段的微创方法:首先,进行左外侧小胸廓切开术,以切除肺动脉;其次,从锁骨上入路,将肺动脉重新植入右颈动脉。
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