Novel Mediastinoscope-Assisted Minimally Invasive Esophagectomy for Esophageal Cancer: A Systematic Review and Meta-analysis

Dabsha, Anas; Elkharbotly, Ismail A M H; Yaghmour, Mohammad; Badr, Amr; Badie, Fady; Khairallah, Sherif; Esmail, Yomna M; Shmushkevich, Shon; Hossny, Mohamed; Rizk, Amr; Ishak, Amgad; Wright, Jessica; Mohamed, Abdelrahman; Rahouma, Mohamed

doi:10.1245/s10434-023-13264-2

Cited by 5 publications

(1 citation statement)

References 59 publications

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“…In recent years, there has been increasing discussion about the potential use of the inflatable mediastinoscopic approach as an option for esophagectomy ( 20 , 21 ). Mediastinoscopic esophagectomy does not require opening of the chest, repositioning or involvement of the lungs, has a shorter operative time, less blood loss, and less postoperative morbidity, while ensuring oncological safety and the reliability of lymph node dissection ( 22 ). This approach is particularly suitable for patients with severe pleural adhesion or those with poor respiratory function.…”

Section: Discussionmentioning

confidence: 99%

A preliminary study of modified inflatable mediastinoscopic and single-incision plus one-port laparoscopic esophagectomy

Tang,

Song,

Wei

et al. 2024

J Thorac Dis

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Background Esophageal malignancies have a high morbidity rate worldwide, and minimally invasive surgery has emerged as the primary approach for treating esophageal cancer. In recent years, there has been increasing discussion about the potential of employing inflatable mediastinoscopic and laparoscopic approaches as an option for esophagectomy. Building on the primary modification of the inflatable mediastinoscopic technique, we introduced a secondary modification to further minimize surgical trauma. Methods We conducted a retrospective analysis of patients who underwent inflatable mediastinoscopy combined with laparoscopic esophagectomy at the Second Affiliated Hospital of Naval Medical University from March 2020 to March 2023. The patients were allocated to the following two groups: the traditional (primary modification) group, and the secondary modification group. Operation times, intraoperative bleeding, and postoperative complications were compared between the groups. Results The procedure was successfully performed in all patients, and conversion to open surgery was not required in any case. There were no statistically significant differences in the surgical operation time, intraoperative bleeding, number of dissected lymph nodes, and rate of postoperative anastomotic leakage between the two groups. However, a statistically significant difference was observed in the length of the mobilized esophagus between the two groups. The mobilization of esophagus to the level of diaphragmatic hiatus via the cervical incision was successfully achieved in more patients in the secondary modification group than the primary modification group. Conclusions Inflatable mediastinoscopy combined with single-incision plus one-port laparoscopic esophagectomy is a safe and effective surgical procedure. The use of a 5-mm flexible endoscope, ultra-long five-leaf forceps, and LigaSure Maryland forceps facilitates esophageal mobilization and lymph node dissection through a single cervical incision.

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Section: Discussionmentioning

confidence: 99%