Transmanubrial approach for en bloc resection of oligometastatic extranodal extension positive lymph nodes with partial common carotid artery and trachea resection after esophagectomy.

Abstract

Background and aims: The transmanubrial approach (TMA) provides excellent exposure of the cervical-thoracic border area, allowing for the resection of thoracic outlet structures while preserving the clavicle, avoiding muscle sacrifice, and maintaining full shoulder mobility.

Methods: This report presents the first instance of TMA being utilized for oligometastatic, extranodal extension-positive lymph node dissection en bloc with partial resection of the common carotid artery and trachea following esophagectomy.

Surgical technique: We describe the surgical technique with illustrated explanations.