Perioperative safety and short-term efficacy of functional minimally invasive esophagectomy

Liu, Huibing; Jin, Defeng; Wang, Qian; Cui, Zhaoqing; Zhang, Luchang; Wei, Yongzhong

doi:10.1177/03000605211010081

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…Motoyama et al reported a case of benign esophageal stricture underwent transhiatal esophagectomy using mediastinoscopy with vagus nerve preservation (7). In 2018, Crema et (9). However, only pulmonary branch of vagus nerve was reserved in this study.…”

Section: Original Articlementioning

confidence: 77%

“…However, only pulmonary branch of vagus nerve was reserved in this study. Nearly all existing literatures reporting on the vagal-sparing technique are case reports or case series about early-stage esophageal carcinoma or benign esophageal disease (6)(7)(8)(9)(10)(11). Meanwhile, minimally invasive esophagectomy (MIE) has been demonstrated to be a safe and feasible alternative to traditional open esophagectomy, with reduced intraoperative and postoperative complications (12).…”

Section: Original Articlementioning

confidence: 99%

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Safety and efficacy of vagus nerve preservation technique during minimally invasive esophagectomy

Chen¹,

Peng²,

Xie³

et al. 2022

Ann Transl Med

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Section: Original Articlementioning

confidence: 77%

Section: Original Articlementioning

confidence: 99%

Safety and efficacy of vagus nerve preservation technique during minimally invasive esophagectomy

Chen¹,

Peng²,

Xie³

et al. 2022

Ann Transl Med

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“…Minimally invasive esophagectomy can be performed safely after neoadjuvant treatment which may include immunotherapy and chemoradiotherapy [9]. Taking into account the results from the immediate postoperative period but also the long-term oncological ones, MIE has become the standard surgical treatment in some countries given the low availability and high cost of using robotic technology [10].…”

Section: Discussionmentioning

confidence: 99%

Early experience in minimally invasive esophagectomy for treatment of thoracic esophageal cancer

Achim

Constantin

Mossen

et al. 2022

Preprint

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Introduction: Minimally invasive esophagectomy (MIE) has gained popularity in the surgical treatment of esophageal cancer over the past three decades. By introducing minimally invasive techniques, esophageal oncological surgery has advanced in terms of safety, radicality, functional preservation and quality of life post-esophagectomy of the patients. Material and Method: We present the experience of the Center of Excellence in Esophageal Surgery at Sf. Maria Clinical Hospital regarding total (MIE) through total 3D HD thoraco-laparoscopic modified McKeown triple approach. In between January 2015 - December 2021, 24 patients (M) were treated for thoracic esophageal cancer. The average age of patients was 57 years. Most of the esophageal tumors were midthoracic (62.5%), 83.3% were squamous carcinomas and half were moderately differentiated. Most of the esophageal tumors were locally advanced tumors (cT3N1 – 58.3%), 18 patients were staged III. 70.8% of patients received neoadjuvant chemo radiotherapy. Results: Thoracoscopic esophageal mobilizations were successful in all 24 patients, no conversion to thoracotomy. Laparoscopic gastric mobilizations were successful in all 24 patients, conversion to open technique was performed in 7 patients for creation extracoporeally of the gastric conduit through an epigastric minilaparotomy. The esophageal substitute was represented by the gastric conduit. The intraoperative blood loss was minimal. The average duration of surgical interventions was 360 minutes. All the surgical interventions were considered with curative intention (R0). The rate of intraoperative complications was 20.8%. The rate of early postoperative complications was 66%. Distribution of postoperative complications according to the Clavien-Dindo Classification (0-33.3%, 1-16.6%, 2-4.1%, 3a-12.5%, 3b-8.3%, 4a-0%, 4b-8.3%, 5-16.6%) highlighted a rate of 33.3% of major complications. The advantages of MIE observed in the studied group in the postoperative period were: reduced postoperative pain, improved comfort and early mobilization of the patients. Conclusions: The early outcomes of using the minimally invasive approach in the treatment of esophageal cancer in our clinic include the reduction of perioperative morbidity, the duration of hospitalization and a faster recovery.

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Mediastinal drainage combined with upper mediastinal re-tunneling vs. mediastinal drainage alone in McKeown esophagectomy of esophageal cancer: a retrospective study

Dai,

Tan,

Chen

et al. 2024

Front. Surg.

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BackgroundAlthough mediastinal drainage may lower the risk of anastomotic leakage, the incident rate of anastomotic leakage is still high. The current study aimed to compare the effects of mediastinal drainage combined with upper mediastinal re-tunneling with mediastinal drainage only on anastomotic leakage after McKeown esophagectomy for esophageal cancer.MethodsFrom October 2018 to March 2021, 52 patients diagnosed as esophageal carcinoma were included in the study. 21 patients received mediastinal drainage combined with upper mediastinal re-tunneling (re-tunneling group) and 31 received mediastinal drainage only (standard group) after McKeown esophagectomy. The incidence rate of anastomotic leakage, mediastinal infection, chylothorax, thoracic infection, the peak value of leukocyte count and the mortality related to anastomotic leakage were compared between the two groups.ResultsOne (4.8%) patient in the re-tunneling group developed anastomotic leakage, and no patient experienced mediastinal infection or thoracic infection. Four (12.9%) patients in the standard group developed anastomotic leakage, and all these patients experienced mediastinal infection and thoracic infection (p < 0.05). The drainage volumes of patients in the re-tunneling group and the standard group were (170 ± 60) ml and (155 ± 45) ml, respectively, with no significant difference between the two groups (p > 0.05). The peak values of leukocyte count and temperature in the re-tunneling group were (14.28 ± 1.12) × 109/L and (38.6 ± 1.1) °C, both lower than that of the standard group[ (16.48 ± 1.15) × 109/L and (38.9 ± 1.2) °C, respectively]. But the difference was not statistically significant (p > 0.05). No anastomotic leakage related death occurred in both groups.ConclusionMediastinal drainage combined with upper mediastinal re-tunneling after McKeown esophagectomy for esophageal cancer may decrease the risk of anastomotic leakage, mediastinal and thoracic infection, reduce the inflammatory response of patients, but did not increase the mortality related to anastomotic leakage.Trial registrationThe study was retrospectively registered.

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Perioperative safety and short-term efficacy of functional minimally invasive esophagectomy

Cited by 3 publications

References 21 publications

Safety and efficacy of vagus nerve preservation technique during minimally invasive esophagectomy

Safety and efficacy of vagus nerve preservation technique during minimally invasive esophagectomy

Early experience in minimally invasive esophagectomy for treatment of thoracic esophageal cancer

Mediastinal drainage combined with upper mediastinal re-tunneling vs. mediastinal drainage alone in McKeown esophagectomy of esophageal cancer: a retrospective study

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