WU Hanran , LIU Changqing , XIE Mingran , WU Xianning , WU Gao , MEI Xinyu
  • Department of Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, P. R. China;
MEI Xinyu, Email: mxyahslyy@163.com
Esophageal neoplasms; inflatable video-assisted mediastinoscopy; esophagectomy; lymph node dissection
10.7507/1007-4848.202501021
Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables References Cited by

Objective To investigate the feasibility, safety, and effectivity of the application of systematic lymph node dissection (SLND) in inflatable video-assisted mediastinoscopic transhiatal esophagectomy (IVMTE). Methods The clinical data of the patients who underwent IVMTE for esophageal cancer in the First Affiliated Hospital of University of Science and Technology of China From January to October 2024 were restrospectively analyzed. They were divided into a SLND group and an elective lymph node dissection (ELND) group according to intraoperative lymph node resection. clinical characteristics and perioperative outcomes were compared between the two groups. Results  A total of 66 patients were enrolled, including 51 males and 15 females, with a mean age of (70.13 ± 8.49) years. There were 12 patients in the selective lymph node dissection (SLND) group and 54 patients in the extended lymph node dissection (ELND) group. There were no statistical differences between the two groups in terms of age, sex, cT stage, tumor location, differentiation grade, pT stage, pN stage, and preoperative comorbidities (P>0.05). statistical differences were observed between the two groups in terms of receiving preoperative neoadjuvant therapy and pTNM staging (P<0.05). There were no statistical differences between the two groups in postoperative complications, operative time, intraoperative blood loss, postoperative hospital stay, and left recurrent laryngeal nerve paratracheal lymph node dissection (P>0.05). The SLND group had a higher average number of lymph nodes dissected, number of stations, number of mediastinal lymph nodes, and number of mediastinal stations than the ELND group. statistical differences were observed between the two groups in the dissection of paraesophageal, right recurrent laryngeal nerve, subcarinal, and diaphragmatic lymph nodes (P<0.05). There were no statistical differences between the two groups in mediastinal lymph node metastasis and cervical lymph node metastasis (P>0.05). The SLND group had more abdominal lymph node metastasis than the ELND group, and the difference was statistically significant (P=0.034). Univariate and multivariate logistic regression analysis showed that cervical lymph node dissection was a risk factor for postoperative complications (P=0.023). Conclusion  SLND is safe and effective in IVMTE. Compared with the ELND group, it increased the number of lymph nodes and stations dissected in the mediastinum, and improved the accuracy of postoperative staging. Meanwhile, it did not prolong operative time or hospital stay, nor did it increase the risk of postoperative complications or non-surgical complications.

Copyright © the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved