Mediastinoscopy-assisted transhiatal esophagectomy versus thoraco-laparoscopic esophagectomy for esophageal cancer: a single-center initial experience

Abstract

Background: We aimed to compare mediastinoscopy-assisted transhiatal esophagectomy (MATHE) with thoraco-laparoscopic esophagectomy (TLE) for patients with esophageal cancer in terms of the clinical effectiveness and perioperative complications. Methods: In total, 98 patients who underwent esophagectomy consecutively for esophageal squamous cell carcinoma in our center from Jan. 2018 to Dec. 2019 were included in this study. Thirty patients underwent mediastinoscopy-assisted and laparoscopic transhiatal esophagectomy with cervical anastomosis (the MATHE group). The other sixty-eight patients received TLE (the TLE group). Each patient's general conditions and perioperative complications were recorded. Results: Patients in the MATHE group were observed to have a higher incidence of postoperative hoarseness than those in the TLE group. There were no significant differences between the MATHE group and the TLE group in regards to the operation time, intraoperative blood loss, number of lymph nodes dissected or postoperative hospital stay. Similarly, no statistically significant differences were observed in the incidence of anastomotic fistula, respiratory complications, or chylothorax or in the conversion rate or inhospital mortality rate between the two groups. Conclusions: The short-term efficacy in the MATHE group was similar to that in the TLE group, although patients in the MATHE group may have had a higher incidence of postoperative hoarseness. Therefore, MATHE may be a feasible and safe surgical procedure for appropriate patients with esophageal cancer.

Home enteral nutrition for postoperative elderly patients with esophageal cancer

“…About 50% of the world's EC incidence and mortality rates are noted in China (1,5). With an attempt to improve the surgical cure of EC in elderly patients, various minimally invasive and endoscopic surgical procedures for malignant esophageal tumors have been described in recent years, focusing on reducing complications and achieving rapid recovery (6)(7)(8). While some foreign studies have reported the nutritional support for recovery from surgery for EC in elderly patients (9), few Chinese articles have investigated this topic.…”

Sternal lifting increases the operating space in esophagectomy via mediastinoscopy: a prospective cohort study

“…it is easy to damage these important adjacent structures during the operation in the narrow mediastinal space (10).…”

“…The lower thoracic esophagus was separated through the esophageal hiatus, and the lymph nodes on the side of the cardiac and lower pulmonary veins were cleared. After the above operation, a vertical incision of 5 cm was made under the xiphoid process, and the stomach was pulled out from the body to form a tubular stomach (10). The tubular stomach was pulled to the neck through the posterior mediastinum.…”

“…So we used sterile ropes to attach the trocar to the fixation rod and the retractor hook, which are used for sternal suspension (Figure 2D). The rest of the procedure was the same as that performed in the NSS group (8,10).…”

Research Progress of the Diagnostic Value of Video Mediastinoscopy in the Staging of Lung Cancer

“…In recent years, with the introduction of new adjuvant treatment programs, people have gradually strict requirements for the accuracy of the diagnosis and staging of lung cancer before treatment [2] . In addition, the limitations of traditional imaging diagnostic methods such as CT and PET in the staging of lung cancer have gradually emerged, so that the application value of mediastinoscopy in the staging of mediastinal lymph nodes of lung cancer and the establishment of standardized treatment plans have gradually attracted people's attention [3] . However, due to the limitation of its own equipment, the traditional mediastinoscopy operation has shortcomings such as narrow surgical field and only one-handed operation, which further reduces the diagnostic accuracy.…”