Minimally invasive esophagectomy performed with the patient in a prone position: a systematic review

Koyanagi, Kazuo; Ozawa, Soji; Tachimori, Yuji

doi:10.1007/s00595-015-1164-9

Cited by 47 publications

(23 citation statements)

References 76 publications

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“…Rino et al (2014) reported that the use of absorbable dense knit hemostat, instead of an electrocautery device, for hemostasis around the RLN could prevent the RLNP during esophageal cancer surgery. Thoracoscopic esophagectomy has been employed as minimally invasive surgery (Saikawa et al 2014;Koyanagi et al 2015). Although magnification of the surgical fields can enable a precise lymph node dissection along the RLN, the advantages of a thoracoscopic esophagectomy for reducing the RLNP continues to be debated.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Laryngeal Nerve Paralysis after Esophagectomy: Respiratory Complications and Role of Nerve Reconstruction

Koyanagi

Igaki

Iwabu

et al. 2015

Tohoku J. Exp. Med.

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Recurrent laryngeal nerve paralysis (RLNP) after esophagectomy is a common complication and associated with aspiration pneumonia. In this study, we assessed the risk of RLNP and the usefulness of immediate reconstruction of recurrent laryngeal nerve (RLN) to prevent respiratory complications after esophagectomy. Seven hundred and eighty-two consecutive patients underwent an esophagectomy with three-field lymph node dissection, simultaneous gastric conduit reconstruction, and cervical anastomosis. Vocal cord function was observed using a flexible laryngoscope. Reconstruction between RLN and ipsilateral vagus nerve was performed during esophagectomy. RLNP was observed in 229 (29.3%) of the patients after esophagectomy: 198 unilateral and 31 bilateral cases. Of the 198 unilateral RLNP, vocal cord paralysis was observed predominantly on the left side (82.7%). RLNP was significantly associated with postoperative respiratory complications (P < 0.001) requiring a tracheotomy (P < 0.001) and mechanical ventilation (P < 0.001) and was also associated with esophagogastric anastomotic leakage (P = 0.015); consequently, the postoperative hospital stay was longer for patients with RLNP (P < 0.001). A longer operation time (P < 0.001) and advanced age (P = 0.038) were identified as significant independent predictors of RLNP. Resection of the RLN together with metastatic nodes was performed in 29 cases. The patients underwent RLN reconstruction (n = 11) had a significantly shorter postoperative hospital stay than those without RLN reconstruction (n = 18) (P = 0.019). In conclusion, RLNP was related to a poorer postoperative course among patients undergoing an esophagectomy. New surgical technologies are recommended for prevention of RLNP.

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Section: Discussionmentioning

confidence: 99%

Recurrent Laryngeal Nerve Paralysis after Esophagectomy: Respiratory Complications and Role of Nerve Reconstruction

Koyanagi

Igaki

Iwabu

et al. 2015

Tohoku J. Exp. Med.

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“…Recent studies from Japan have shown the benefits of MIE in the prone position in terms of better surgical exposure, a larger number of dissected lymph nodes and less blood loss compared to MIE in the left lateral decubitus position. However, most cases undergo MIE in the left lateral decubitus or semi‐prone position in China .…”

Section: Discussionmentioning

confidence: 99%

“…Esophagectomy with radical lymphadenectomy plays the most vital role in treating patients with esophageal cancer. With the development of endoscopic equipment and the progress of surgical technology, minimally invasive esophagectomy (MIE), which is characterized by minimal access, lower postoperative pain, fewer complications and fast recovery, has become the treatment of choice in recent years …”

Section: Introductionmentioning

confidence: 99%

Comparative study of three types of lymphadenectomy along the left recurrent laryngeal nerve by minimally invasive esophagectomy

Zhang

Guo

et al. 2019

Thoracic Cancer

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Background: The objective of this study was to compare three kinds of lymphadenectomy methods along the recurrent laryngeal nerve (RLN) and assess the safety and effectiveness of the new method. Methods: A total of 194 patients with esophageal cancer who underwent minimally invasive esophagectomy (MIE) at our institution from May 2013 to May 2017 were analyzed retrospectively. According to the method of lymphadenectomy along the left RLN, the patients were divided into three groups: 75 cases underwent the conventional method (A group), 80 cases the skeletonized method (B group) and 39 cases the modified Bascule method (C group). The number of dissected lymph nodes and surgical outcomes were recorded and compared to identify differences among the three groups. Results: The frequency of metastasis to the LRLN lymph node was 18.6% among all patients, and 12%, 20% and 28% in groups A, B and C, respectively. The number of harvested lymph nodes (total/chest/LRLN/LRLN+) in group B and group C were significantly greater than that of group A, but not significant between group B and group C. The hoarseness rate in group C was 15.4%, which was lower than the rate in group B (21.3%) and higher than the rate in group A (13.3%), but there was no statistical significance. Conclusions: The new method for lymphadenectomy along the left RLN during MIE in the semi-prone position is safe and reliable. It provides sufficient lymph node dissection along the left RLN.

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“…Geralmente, os divertículos de tração não apresentam sintomas, porém dependendo do tamanho do divertículo e do estágio da doença é comum o aparecimento de disfagia, regurgitação, mau hálito, rouquidão ou pneumopatias (5) . Aspiração, tosse e complicações, como a infecção, a perfuração e a transformação neoplásica, são razões pelas quais o tratamento cirúrgico é recomendado (6) .…”

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Diverticulo De Esofago Médio: Relato De Caso

Ayub¹,

Nunes²,

Costa³

et al. 2017

ACS

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Introdução: Divertículos esofagianos são alterações esofágicas raras e podem ser classificados em proximais, médios ou distais, de acordo com a localização. Podem ser de pulsão ou tração e verdadeiro ou falso. Na dependência do tamanho do divertículo e da concomitância de doença associada, podem causar disfagia, regurgitação, mau hálito, rouquidão ou pneumopatias, podendo ter indicação de ressecção cirúrgica. O diagnóstico é suspeitado pela história clínica e confirmado pelo exame radiológico contrastado e pela endoscopia digestiva alta. Objetivo: Relatar o caso raro de uma paciente com divertículo de esôfago médio. Materiais e Métodos: Revisão do prontuário, registro fotográfico dos métodos diagnósticos e revisão da literatura. Resultados: Paciente feminina, 61 anos, encaminhada ao ambulatório do hospital de base de São José do Rio Preto, com queixa de disfagia progressiva para alimentos sólidos aproximadamente há cinco anos, associado à odinofagia, eructação intensa e perda ponderal nesse período de 10 quilos. A endoscopia digestiva alta, mostrou divertículo no terço médio do esôfago, 25 cm da arcada dentária superior, com óstio de 3-4 cm de diâmetro e 3 cm de profundidade. A tomografia computadorizada de tórax confirmou a presença do divertículo de esôfago em terço médio do esôfago, sem outros achados que justificassem sua presença. A paciente foi submetida à videotoracoscopia com ressecção do divertículo sem intercorrências. Atualmente, a paciente apresenta-se assintomática no acompanhamento clínico. Conclusão: Embora seja considerada uma alteração esofágica rara, os divertículos esofagianos, devem sempre ser considerados como diagnóstico diferencial. Especialmente em casos de disfagia, halitose e enfermidades respiratórias por broncoaspiração. Em casos de pacientes sintomáticos e com dificuldade no tratamento clinico, a melhor opção terapêutica é a cirurgia com a excisão local do divertículo via toracotomia ou toracoscopia.

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Minimally invasive esophagectomy performed with the patient in a prone position: a systematic review

Abstract: Theoretically, the operative results of MIE-PP might be better than those of MIE-LP for patients with esophageal cancer; however, studies have not yet verified this. Further clinical studies are required to establish whether the advantages of MIE-PP can be translated into clinical outcome.

Cited by 47 publications

References 76 publications

Recurrent Laryngeal Nerve Paralysis after Esophagectomy: Respiratory Complications and Role of Nerve Reconstruction

Recurrent Laryngeal Nerve Paralysis after Esophagectomy: Respiratory Complications and Role of Nerve Reconstruction

Comparative study of three types of lymphadenectomy along the left recurrent laryngeal nerve by minimally invasive esophagectomy

Diverticulo De Esofago Médio: Relato De Caso

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