RA07.08: SURGICAL AND PATHOLOGICAL IMPACT OF THE NOVEL CLASSIFICATION OF AN ANATOMY OF BRONCHIAL ARTERIES IN PATIENTS WHO UNDERWENT ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

Abstract

Abstract Background The first systematic classification of an anatomy of bronchial arteries (BAs) is reported by Cauldwell E. W. in 1948. However, it is not suitable for recognizing anatomy of BAs for esophageal surgery since it does not contain information of relative position of BAs and esophagus. So, the aim of this study is to device a novel classification of BAswhich correlates with surgical and pathological factors of esophageal cancer. Methods Eighty-six patients that have undergone curative esophagectomy from April 2012 to March 2016 for esophageal cancer whose epicenter is located in midthoracic esophagus were enrolled. Dynamic-enhanced computed tomography imaging (dCT) and clinico-pathological factors were analyzed. The right (rt-) BA which runs along the right side of esophagus is defined as Median (M) type and rt-BA which runs along the left side of esophagus is defined as Lateral (L) type. Also, the BA which arises from right side of aortic arch and runs down aortopulmonary window is defined as Tracheal (T) type and the others are defined as Bronchial (B) type. We classified patients by combination of M/L type and T/B type. Results dCT was performed in 81 cases. The number of patients with type of MT, MB, LT and LB were 19, 46, 12 and 4, respectively. Existence of rt-2nd-BA is significantly frequent in LB type and existence of lt-2nd-BA is significantly frequent in M type (P < 0.001, P = 0.012, respectively). Also, rt and lt BA forms common trunk significantly frequent in patients with LT type (P = 0.012). As for pathological factors, 38 patients had pathological lymph node metastasis. Among these patients, MT type patients have significantly more metastasis-positive lymph nodes (mLN) in #107 (P = 0.006) and LT type patients have significantly more mLN nodes in #105 (P = 0.039). Also, we compared pretreatment diagnosis of metastasis positive LNs (pre-mLNs) and pathological metastasis positive LNs. And we found that false- falsenegative cases of pretreatment diagnosis are significantly frequent in M type on #105 and cases with absence of lt-2nd-BA on #106recR (P = 0.038, P = 0.018, respectively). Conclusion Classifying an anatomy of BAs by relative position to esophagus and their origin is possibly helpful in esophageal surgery. Disclosure All authors have declared no conflicts of interest.