Clinical application and observation of single-port inflatable mediastinoscopy combined with laparoscopy for radical esophagectomy in esophageal squamous cell carcinoma

Autor: Wenhao Wang, Shaohui Zhou, Lijun Liu, Yongbin Song, Xuejiao Xun, Huining Liu, Peng Qie, Qifan Yin, Guang Yang
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Esophageal Neoplasms
medicine.medical_treatment
Fistula
Esophageal cancer
Blood Loss
Surgical
Constriction
Pathologic
Mediastinoscopy
0302 clinical medicine
Postoperative Complications
Laparotomy
Medicine
Laparoscopy
medicine.diagnostic_test
General Medicine
Middle Aged
Cardiac surgery
Thoracotomy
Cardiothoracic surgery
Esophagectomy
030220 oncology & carcinogenesis
Drainage
030211 gastroenterology & hepatology
Female
Esophageal Squamous Cell Carcinoma
Cardiology and Cardiovascular Medicine
Research Article
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Operative Time
lcsh:Surgery
lcsh:RD78.3-87.3
03 medical and health sciences
Humans
Aged
business.industry
lcsh:RD1-811
Length of Stay
medicine.disease
Surgery
Non-transthoracic esophagectomy
lcsh:Anesthesiology
Recurrent Laryngeal Nerve Injuries
Lymph Node Excision
business
Inflatable mediastinoscopy and laparoscopy
Zdroj: Journal of Cardiothoracic Surgery, Vol 15, Iss 1, Pp 1-7 (2020)
Journal of Cardiothoracic Surgery
ISSN: 1749-8090
DOI: 10.1186/s13019-020-01168-1
Popis: Background Transthoracic esophagectomy is a crucial independent risk factor for the incidence of postoperative cardiopulmonary complications in elderly or comorbid patients. To reduce postoperative cardiopulmonary complications and promote postoperative recovery. We made an attempt to adopt the single-port inflatable mediastinoscopy combined with laparoscopy for radical esophagectomy in esophageal cancer to observe the clinical application and effect. Method Data of patients with esophageal carcinoma were collected in the Hebei General Hospital from May 2018 to November 2019. The operation time, surgical blood loss, the number of dissected lymph nodes, duration of drainage tube, duration of time on the ventilator, the length of stay in ICU, postoperative complications, the length of postoperative hospital stay were collected to assess the safety and feasibility of the single-port inflatable mediastinoscopy combined with laparoscopy for radical esophagectomy in esophageal cancer. Results A total of 22 patients with esophageal cancer were analyzed in our research. There were no cases of conversion to thoracotomy、perioperative death or postoperative cardiopulmonary complications. The average operation time of all enrolled patients was 4.26 ± 0.52 h、The surgical blood loss was 142 ± 36.50 ml、The amount of dissected lymph nodes were 21.6 ± 4.2、The duration of drainage tube was 5.8 ± 2.5 days、The duration of time on the ventilator was 6.5 ± 3.4 h、The length of stay in ICU was 1.2 ± 0.4 days、The postoperative hospital stay was 12.6 ± 2.5 days. Among all the enrolled patients, one patient (4.5%) developed anastomotic fistula on the third day after surgery. Anastomotic stricture was found in 5 patients (22.7%). Pleural effusion was found in 4 cases (18.2%). Recurrent laryngeal nerve injury caused hoarseness or cough after drinking water in 3 cases (13.6%).There was one patient (4.5%) of conversion to laparotomy as the patient had serious peritoneal adhesion. All of the patients were discharged successfully. Conclusion:Our results showed that this surgery of single-port inflatable mediastinoscopy combined with laparoscopy for radical esophagectomy in esophageal squamous cell carcinoma is safe and feasible. The feasibility and safety could be further and better investigated with a RCT to achieve more conclusive results.
Databáze: OpenAIRE
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