Transthoracic Single-Port Assisted Laparoscopic Five-Step Maneuver Lower Mediastinal Lymphadenectomy for Siewert Type II Adenocarcinoma of the Esophagogastric Junction

Xiong, Wenjun; Chen, Yan; Zhu, Xiaofeng; Luo, Sijing; Peng, Yaohui; Li, Jin; Zheng, Yansheng; Luo, Lijie; Cui, Ziming; Wan, Jin; Wang, Wei

doi:10.1245/s10434-022-11369-8

Cited by 2 publications

(1 citation statement)

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“…Surgical procedures were performed as Five ⁃ step maneuver reported by our team previously during which the right pleura wasn’t routinely opened [ 16 ]. Key procedures were as follows: the perigastric lymph node dissection was performed according to D2 lymph node dissection based on the Japanese gastric cancer treatment guidelines [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

Whether the infracardiac bursa protect right pleura during laparoscopic radical operation of Siewert type II adenocarcinoma of esophagogastric junction?

Lin

Zeng²,

Xiong³

et al. 2022

BMC Cancer

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Background Transthoracic single-port assisted laparoscopic five-step maneuver inferior mediastinal lymphadenectomy for Siewert type II adenocarcinoma of esophagogastric junction (AEG) has superiority in lower mediastinal lymph nodes dissection and digestive tract reconstruction. However, the right pleura was probably ruptured in this surgical technique. The aim of this study was to explore whether the infracardiac bursa (ICB) exposed could protect right pleura. Methods We retrospectively collected and evaluated the clinical and pathological data of patients who underwent five-step maneuver of transthoracic single-port assisted laparoscopic lower mediastinal lymphadenectomy for Siewert II AEG at Guangdong Provincial Hospital of Chinese Medicine between May 2017 and February 2022. Results A total of 49 patients were eligible, including 31 patients in ICB exposed group (group A) and 18 patients in ICB unexposed group (group B). There were no statistically significant differences in baseline characteristics between the two groups. 4 patients (12.9%) had right pleura rupture in group A, while 14 patients (77.8%) in group B, and the difference was statistically significant (p < 0.001). Compared with group B, the extubation time of endotracheal intubation (10.0 (6.0 ~ 12.0) vs. 13.0 (8.0 ~ 15.0) min, p = 0.003) and thoracic drainage tube stay (6.0 (5.0 ~ 7.0) vs. 8.0 (6.0 ~ 10.5) days, p = 0.041) were significantly shorted in the group A. The drainage volume of thorax (351.61 ± 125.00 vs. 418.61 ± 207.86 mL, p = 0.146) was non-significant less and the rate of complications (3.2% vs. 11.1%, p = 0.074) was non-significant lower in group A compared with group B. The postoperative hospital stay (9.0 (8.0,13.0) vs. 9.0 (8.0,12.0) days, p = 0.983) were similar in two groups. No serious adverse event occurred in any patient. Conclusions The ICB exposed could protect the right pleura and may promote postoperative recovery, which may be used as an anatomical marker in inferior mediastinal lymphadenectomy.

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Section: Methodsmentioning

confidence: 99%