Mediastinoscopy-assisted esophagectomy for T2 middle and lower thoracic esophageal squamous cell carcinoma patients

Wang, Jun; Wei, Ning; Lu, Yimin; Zhang, Xiaoying; Jiang, Nanqing

doi:10.1186/s12957-018-1361-2

Cited by 13 publications

(18 citation statements)

References 23 publications

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“…Although published reports had compared the 2 surgical methods, the best surgical method for treating esophageal cancer was still considerably controversial. Those published studies 3,6,10 had a different focus, and several of them did not conduct survival analysis. Our study comprehensively compared the intraoperative, postoperative, and survival outcomes of MATHE and TATTE.…”

Section: Discussionmentioning

confidence: 99%

A Case-Control Study on the Therapeutic Effect of Mediastinoscope-Assisted and Thoracoscope-Assisted Esophagectomy

et al. 2020

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Objective. To compare the clinical efficacies of mediastinoscope-assisted and thoracoscope-assisted esophagectomy. Materials and Methods. Seventy-six patients with esophageal cancer who underwent minimally invasive esophagectomy at the General Hospital of Ningxia Medical University between June 2015 and January 2019 were retrospectively evaluated. Among them, 28 patients underwent mediastinoscope-assisted transhiatal esophagectomy (MATHE), and 48 received thoracoscope-assisted transthoracic esophagectomy (TATTE). The perioperative clinical data and follow-up data of the 2 groups were compared. Results. All operations were successful in both groups. MATHE was favorable in terms of operation time, intraoperative blood loss, drainage volume 3 days after surgery, postoperative hospital stay, and hypoproteinemia ( P < .05). Lymph node dissections were less than those in the TATTE ( P < .05). No significant differences in long-term postoperative complications and survival rate were found between the 2 groups ( P > .05). Conclusion. MATHE has the advantages of minimal trauma, shorter operation time, less intraoperative blood loss, and faster recovery. More adequate tumor clearance in terms of lymph node dissection can be achieved with TATTE. However, the comparison of survival rates between the 2 groups is similar.

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Section: Discussionmentioning

confidence: 99%

A Case-Control Study on the Therapeutic Effect of Mediastinoscope-Assisted and Thoracoscope-Assisted Esophagectomy

et al. 2020

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“…9 In a similar study in 2004, 42 esophageal cancer patients underwent MAE and the results showed less bleeding during surgery, shorter duration of surgery, and the possibility of greater lymph node resection. 10 Wang and colleagues 11 operated on 112 T2 stage esophageal cancer patients, using Ivor Lewis esophagectomy (81 patients) and mediastinoscope-assisted esophagectomy (31 patients). The duration of surgery and intraoperative blood loss in the MAE method were less than in the Ivor Lewis method, but patient survival did not depend on the surgical method and the involvement of the lymph nodes was more effective.…”

Section: Discussionmentioning

confidence: 99%

Comparison of transhiatal esophagectomy using a mediastinoscope with transhiatal esophagectomy by the classic method

Rezaei

Masuom

Soroush

et al. 2020

Asian Cardiovasc Thorac Ann

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Background This study aimed to evaluate the results of transhiatal esophagectomy using a mediastinoscope in comparison with conventional transhiatal esophagectomy. Methods Sixty-two esophageal cancer patients who were referred to our thoracic surgery clinic between April 2015 and March 2017, and met the inclusion criteria, were randomly divided into two groups of 31 each. In the first group, patients were operated on by conventional transhiatal esophagectomy. In the second group, only release of the thoracic esophagus through a neck incision (mediastinal esophagolysis) was performed using a mediastinoscope. The other surgical procedures were similar to those in the first group. Results The mean age of the patients was almost the same in both groups (57.7 years in the first group versus 56.7 years in the second group). There was no significant difference in sex ratio. The mean volume of blood loss during the operation, mean operative time, and intensive care unit stay as well as cardiopulmonary complications and early postoperative complications were lower in the group that had esophagectomy using a mediastinoscope, and the number of resected mediastinal lymph nodes was greater. Conclusion Based on the results of this study, it can be expected that use of a video mediastinoscope for esophagolysis of the thoracic esophagus in a transhiatal esophagectomy procedure is safe and it will reduce the morbidity and mortality in these patients.

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“…The stomach is fixed to the left thorax in the Sweet procedure, but to the right thorax in the Ivor-Lewis procedure. [9] Fixing the stomach to the right thorax induces an inappropriate angle between the pyloric region and stomach; [6] this may explain for the delay in gastric emptying.…”

Section: Discussionmentioning

confidence: 99%

“…The Ivor-Lewis procedure was carried out as described previously. [6] Under general anesthesia by tracheal cannula, the supine position was adopted for the dissociation of the stomach and lymphadenectomy of the abdominal lymph nodes via a median incision in the upper abdomen. The patients were assigned to the left lateral position for dissociation of the thoracic esophagus to clear the way for access to the thoracic lymph nodes via a posterolateral incision in the 5th intercostal space.…”

Section: Methodsmentioning

confidence: 99%

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Comparison of Ivor-Lewis versus Sweet procedure for middle and lower thoracic esophageal squamous cell carcinoma

et al. 2019

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Our study compared the Ivor-Lewis and Sweet procedures used for treating middle and lower thoracic esophageal squamous cell carcinoma and assessed the associated perioperative complications and long-term survival rates of the patients. This retrospective study involved 624 middle and lower thoracic esophageal squamous carcinoma patients who received either Ivor-Lewis (n = 325) or Sweet (n = 299) procedures at our hospital. Further, the perioperative conditions and long-term survival rates were analyzed for both groups. Relative to the Sweet group, the Ivor-Lewis group showed lower volume of drainage within 24 hours after operation (400 (300–500) ml vs 550 (400–658) ml, P = .031). Although we found no significant differences in major postoperative complications between the groups (72 (22.2) vs 65 (21.7), P = .90), there were significant differences observed in minor postoperative complications between the Ivor-Lewis and Sweet groups (59 (18.2) vs 32 (10.7), P = .008). Perioperative death rates remained comparable for the 2 groups (2 (0.6) vs 2 (0.7), P > .99). Further, comparison of the 2 groups revealed that the Ivor-Lewis group had increased number of dissected lymph nodes, (20 (4–42) vs 16 (3–31), P < .001), especially in the upper mediastinum (4 (0–5) vs 2 (0–2), P < .001). The long-term survival rates did not differ significantly between the 2 groups (Kaplan-Meier method, P = .95; Cox regression, P = .20). These findings suggest that perioperative complications and long-term survival rates were comparable for both patients groups. Patients receiving the Sweet procedure had reduced minor postoperative complications compared to those receiving the Ivor-Lewis procedure. Due to improved quality of lymph node dissection in the upper mediastinum, the Ivor-Lewis procedure may have advantages over the Sweet procedure for treating patients with esophageal cancer with enlarged lymph nodes in the upper mediastinum.

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Mediastinoscopy-assisted esophagectomy for T2 middle and lower thoracic esophageal squamous cell carcinoma patients

Cited by 13 publications

References 23 publications

A Case-Control Study on the Therapeutic Effect of Mediastinoscope-Assisted and Thoracoscope-Assisted Esophagectomy

A Case-Control Study on the Therapeutic Effect of Mediastinoscope-Assisted and Thoracoscope-Assisted Esophagectomy

Comparison of transhiatal esophagectomy using a mediastinoscope with transhiatal esophagectomy by the classic method

Comparison of Ivor-Lewis versus Sweet procedure for middle and lower thoracic esophageal squamous cell carcinoma

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