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A comparison of the surgical invasiveness and short-term outcomes between thoracoscopic and pneumatic mediastinoscopic esophagectomy for esophageal cancer

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Abstract

Purpose

Minimally invasive esophagectomy (MIE) has been widely accepted as a treatment for esophageal cancer. This retrospective study compared the short-term outcomes and surgical invasiveness between thoracoscopic esophagectomy (TE) and mediastinoscopic esophagectomy with pneumomediastinum (pneumatic mediastinoscopic esophagectomy [PME]).

Methods

A total of 72 patients who underwent TE or PME were included and assessed for their surgical findings, postoperative complications, and inflammatory responses on postoperative day (POD) 1, 3, 5, and 7.

Results

The PME group exhibited a significantly shorter operative time and fewer lymph nodes retrieved than the TE group. Furthermore, the PME group tended to have greater incidences of recurrent laryngeal nerve palsy and lower incidences of atelectasis than the TE group. The PME group had significantly lower white blood cell counts on POD 5, serum C-reactive protein (CRP) levels on POD 3 than the TE group.

Conclusion

PME seems to be less invasive than TE and can be considered the preferred option for patients with lower-stage esophageal cancer expected to have severe pleural adhesion or who cannot tolerate TE.

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Authors and Affiliations

  1. Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima, 890-8520, Japan

    Ken Sasaki, Yusuke Tsuruda, Masataka Shimonosono, Masahiro Noda, Yasuto Uchikado, Daisuke Matsushita, Yoshiaki Kita, Shinichiro Mori, Hiroshi Kurahara, Akihiro Nakajo & Takao Ohtsuka

  2. Department of Onco-Biological Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima, 890-8520, Japan

    Takaaki Arigami

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  1. Ken Sasaki
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  2. Yusuke Tsuruda
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Correspondence to Ken Sasaki.

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Sasaki, K., Tsuruda, Y., Shimonosono, M. et al. A comparison of the surgical invasiveness and short-term outcomes between thoracoscopic and pneumatic mediastinoscopic esophagectomy for esophageal cancer. Surg Today 52, 1759–1765 (2022). https://doi.org/10.1007/s00595-022-02509-4

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  • DOI: https://doi.org/10.1007/s00595-022-02509-4

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