Background Transthoracic esophagectomy is a crucial independent risk factor for the incidence of postoperative cardiopulmonary complications in elderly or comorbid patients. To reduce postoperative cardiopulmonary complications and promote postoperative recovery. We made a bold attempt to adopt the single-port inflatable mediastinoscopy combined with laparoscopy for radical esophagectomy in esophageal cancer to observe the clinical application and effect.
Method Data of patients with esophageal carcinoma were collected in the Hebei General Hospital from May 2018 to November 2019. The operation time、surgical blood loss、the number of dissected lymph nodes、duration of drainage tube、postoperative complications、the length of postoperative hospital stay were collected to assess the safety and feasibility of the single-port inflatable mediastinoscopy combined with laparoscopy for radical esophagectomy in esophageal cancer.
Results A total of 22 patients with esophageal cancer were analyzed in our research. There was no case of switching to thoracotomy、perioperative death or postoperative cardiopulmonary complications. The average operation time、surgical blood loss、amount of dissected lymph nodes、duration of drainage tube、postoperative hospital stay of all enrolled patients was 4.26±0.52 hours、142±36.50 ml、21.6±4.2、5.8±2.5 days、12.6±2.5 days, respectively. Among all the enrolled patients, one patient(4.5%) developed anastomotic fistula on the third day after surgery. 5 patients(22.7%) with anastomotic stricture. Pleural effusion was found in 4 cases (18.2%). Recurrent laryngeal nerve injury caused hoarseness or cough after drinking water in 3 cases (13.6%). one patients(4.5%) was switched from laparoscopy to open surgery as the patient had serious peritoneal adhesion. All of the patients were discharged successfully.
Conclusion Our results showed that this surgery of single-port inflatable mediastinoscopy combined with laparoscopy for radical esophagectomy in esophageal squamous cell carcinoma is safe and feasible. The feasibility and safety could be further and better investigated with a RCT to achieve more conclusive results.