Transhiatal bilateral cervical approach for mediastinoscopy-assisted esophagectomy: A retrospective cohort study.

Autor: Jiang YQ; Department of thoracic surgery, Chongqing University cancer Hospital, Chongqing, China., Xing HJ; Department of thoracic surgery, Chongqing University cancer Hospital, Chongqing, China., Teng F; Department of thoracic surgery, Chongqing University cancer Hospital, Chongqing, China., Huang Y; Department of thoracic surgery, Chongqing University cancer Hospital, Chongqing, China., Yao JK; Department of thoracic surgery, Chongqing University cancer Hospital, Chongqing, China., Wang ZQ; Department of thoracic surgery, Chongqing University cancer Hospital, Chongqing, China.
Jazyk: angličtina
Zdroj: World journal of surgery [World J Surg] 2024 Feb; Vol. 48 (2), pp. 427-436. Date of Electronic Publication: 2024 Jan 04.
DOI: 10.1002/wjs.12061
Abstrakt: Background: The McKeown minimally invasive esophagectomy (McMIE) procedure has various limitations, including surgical contraindications and a high rate of postoperative pulmonary complications. A novel mediastinoscopic esophagectomy procedure was described in this study by using esophageal invagination and a transhiatal and bilateral cervical approach (EITHBC).
Methods: According to the mode of operation, a total of 259 patients were divided into two groups, among which 106 underwent EITHBC and 153 underwent McMIE. The number of lymph nodes dissected, intraoperative outcomes, and postoperative outcomes were compared between the two groups of patients.
Results: The results revealed that the average number of resected lymph node in the EITHBC group was significantly higher in the recL106 and TbL106 stations (recL106: 1.75 vs. 1.51, p = 0.016, TbL106: 1.53 vs. 1.19, p = 0.016) and significantly lower in the 107 stations (1. 74 vs. 2. 07, p < 0.001) than in the McMIE group. The intraoperative blood loss in the EITHBC group was significantly lower than that in the McMIE group (63.30 vs. 80.45 mL, p < 0.001). The incidence of postoperative pulmonary complications in the EITHBC group was lower than that in the McMIE group (14.15% vs. 27.45%, p = 0.008). The incidence of recurrent laryngeal nerve paralysis in the EITHBC group was significantly higher than that in the McMIE group (26.41% vs. 10.46%, p = 0.003).
Conclusion: Compared with the McMIE procedure, the EITHBC procedure has advantages in terms of removing the upper mediastinal lymph nodes and reducing postoperative pulmonary complications.
(© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).)
Databáze: MEDLINE
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