Spatial relationships of the bronchial arteries to the left recurrent laryngeal nerve in the sub-aortic arch area
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).
For this macro-anatomical study, 72 cadavers were used.
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.
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.
KeywordsEsophageal cancer Lymphadenectomy Bronchial artery Left recurrent laryngeal nerve Anatomy
The authors appreciate the contribution of the Deigo-Kai, the voluntary body donation organization of the University of the Ryukyus, for allowing our macro-anatomical studies of the cadavers.
Compliance with ethical standards
Conflict of interest
The authors declare no conflicts of interest in association with this study.