Short-term follow-up results of inflatable mediastinoscopy combined with laparoscopy <i>versus</i> video-assisted thoracoscopic surgery combined with laparoscopy for esophageal cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

FANG Yunhao , CHEN Zihao , WEI Rongqiang , HUANG Kenan , DING Xinyu , LIU Chengdong , XU Zhifei , WU Bin ,  TANG Hua

Minimally Invasive Thoracic Surgery Center, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, P.R.China;

Corresponding author：

TANG Hua, Email: tangh_mits@163.com

Keywords：

Inflatable mediastinoscopy; thoracoscopy; esophageal cancer; complications; survival rate

DOI：

10.7507/1007-4848.202004062

Video：

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Objective To investigate the short-term follow-up results of inflatable mediastinoscopy combined with laparoscopy in the treatment of esophageal cancer.Methods Clinical data of 102 patients with esophageal cancer who underwent minimally invasive esophagectomy were enrolled in our hospital from January 2017 to January 2019. Patients were divided into two groups according to different surgical methods, including a single-port inflatable mediastinoscopy combined with laparoscopy group (group A, n=59, 53 males and 6 females, aged 63.3±7.6 years, ranging from 45 to 75 years) and a video-assisted thoracoscopy combined with laparoscopy group (group B, n=43, 35 males and 8 females, aged 66.7±6.7 years, ranging from 50-82 years). The short-term follow-up results of the two groups were compared.Results Compared with the group A, the rate of postoperative pulmonary complication of the group B was significantly lower (18.64% vs. 4.65%, P<0.05). There was no significant difference between the two groups in other postoperative complications (P>0.05). The 6-month, 1-year, and 2-year survival rates were 96.61%, 89.83%, and 73.33%, respectively in the group A, and were 95.35%, 93.02%, and 79.17%, respectively in the group B. There was no significant difference in short-term survival rate after operation (P>0.05).Conclusion In the treatment of esophageal cancer, the incidence of pulmonary complications of inflatable mediastinoscopy combined with laparoscopy is lower than that of traditional video-assisted thoracoscopy combined with laparoscopy, and there is no significant difference in other postoperative complications or short-term survival rate between the two methods. Inflatable mediastinoscopy combined with laparoscopy for radical esophageal cancer is a relatively safe surgical method with good short-term curative effects, and long-term curative effects need to be further tested.

Citation： FANG Yunhao, CHEN Zihao, WEI Rongqiang, HUANG Kenan , DING Xinyu, LIU Chengdong, XU Zhifei, WU Bin, TANG Hua. Short-term follow-up results of inflatable mediastinoscopy combined with laparoscopy versus video-assisted thoracoscopic surgery combined with laparoscopy for esophageal cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(2): 239-242. doi: 10.7507/1007-4848.202004062 Copy

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2.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3.	Biere SS, van Berge Henegouwen MI, Bonavina L, et al. Predictive factors for post-operative respiratory infections after esophagectomy for esophageal cancer: outcome of randomized trial. J Thorac Dis, 2017, 9(Suppl 8): S861-S867.
4.	Yibulayin W, Abulizi S, Lv H, et al. Minimally invasive oesophagectomy versus open esophagectomy for resectable esophageal cancer: a meta-analysis. World J Surg Oncol, 2016, 14(1): 304.
5.	Markar S, Gronnier C, Duhamel A, et al. Pattern of postoperative mortality after esophageal cancer resection according to center volume: Results from a large European multicenter study. Ann Surg Oncol, 2015, 22(8): 2615-2623.
6.	Ando N, chief editor. Esophageal Squamous Cell Carcinoma. Tokyo: Springer, 2015. 151.
7.	Fujiwara H, Shiozaki A, Konishi H, et al. Single-port mediastinoscopic lymphadenectomy along the left recurrent laryngeal nerve. Ann Thorac Surg, 2015, 100(3): 1115-1117.
8.	Fujiwara H, Shiozaki A, Konishi H, et al. Perioperative outcomes of single-port mediastinoscope-assisted transhiatal esophagectomy for thoracic esophageal cancer. Dis Esophagus, 2017, 30(10): 1-8.
9.	Li GS. Prof. Qingdong Cao: single-port inflatable mediastinoscopy combined with laparoscopy for the radical treatment of esophageal cancer. J Thorac Dis, 2016, 8(9): E1108-E1109.
10.	Wang X, Li X, Cheng H, et al. Single-port inflatable mediastinoscopy combined with laparoscopic-assisted small incision surgery for radical esophagectomy is an effective and safe treatment for esophageal cancer. J Gastrointest Surg, 2019, 23(8): 1533-1540.
11.	Gan X, Wang X, Zhang B, et al. Lymphadenectomy along bilateral recurrent laryngeal nerves under single-incision mediastinoscopy. Ann Thorac Surg, 2020, 109(6): e449-e452.
12.	Cuschieri A. Endoscopic subtotal oesophagectomy for cancer using the right thoracoscopic approach. Surg Oncol, 1993, 2(Suppl 1): 3-11.
13.	Mariette C, Markar S, Dabakuyo-Yonli TS, et al. Health-related quality of life following hybrid minimally invasive versus open esophagectomy for patients with esophageal cancer, analysis of a multicenter, open-label, randomized phase Ⅲ controlled trial: The MIRO trial. Ann Surg, 2020, 271(6): 1023-1029.
14.	Luketich JD, Pennathur A, Franchetti Y, et al. Minimally invasive esophagectomy: results of a prospective phase Ⅱmulticenter trial-the eastern cooperative oncology group (E2202) study. Ann Surg, 2015, 261(4): 702-707.
15.	Biere SS, van Berge Henegouwen MI, Maas KW, et al. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet, 2012, 379(9829): 1887-1892.
16.	Sakamoto T, Fujiogi M, Matsui H, et al. Comparing perioperative mortality and morbidity of minimally invasive esophagectomy versus open esophagectomy for esophageal cancer: A nationwide retrospective analysis. Ann Surg, 2019, Epub ahead of print.
17.	Mamidanna R, Bottle A, Aylin P, et al. Short-term outcomes following open versus minimally invasive esophagectomy for cancer in England: a population-based national study. Ann Surg, 2012, 255(2): 197-203.
18.	Moon DH, Lee JM, Jeon JH, et al. Clinical outcomes of video-assisted thoracoscopic surgery esophagectomy for esophageal cancer: a propensity score-matched analysis. J Thorac Dis, 2017, 9(9): 3005-3012.
19.	Smithers BM, Gotley DC, Martin I, et al. Comparison of the outcomes between open and minimally invasive esophagectomy. Ann Surg, 2007, 245(2): 232-240.
20.	Venissac N, Pop D, Mouroux J. Video-assisted mediastinoscopy as a therapeutic tool. Surg Endosc, 2009, 23(11): 2466-2472.
21.	Wang QY, Tan LJ, Feng MX, et al. Video-assisted mediastinoscopic resection compared with video-assisted thoracoscopic surgery in patients with esophageal cancer. J Thorac Dis, 2014, 6(6): 663-667.
22.	Bonavina L, Incarbone R, Bona D, et al. Esophagectomy via laparoscopy and transmediastinal endodissection. J Laparoendosc Adv Surg Tech A, 2004, 14(1): 13-16.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3. Biere SS, van Berge Henegouwen MI, Bonavina L, et al. Predictive factors for post-operative respiratory infections after esophagectomy for esophageal cancer: outcome of randomized trial. J Thorac Dis, 2017, 9(Suppl 8): S861-S867.
4. Yibulayin W, Abulizi S, Lv H, et al. Minimally invasive oesophagectomy versus open esophagectomy for resectable esophageal cancer: a meta-analysis. World J Surg Oncol, 2016, 14(1): 304.
5. Markar S, Gronnier C, Duhamel A, et al. Pattern of postoperative mortality after esophageal cancer resection according to center volume: Results from a large European multicenter study. Ann Surg Oncol, 2015, 22(8): 2615-2623.
6. Ando N, chief editor. Esophageal Squamous Cell Carcinoma. Tokyo: Springer, 2015. 151.
7. Fujiwara H, Shiozaki A, Konishi H, et al. Single-port mediastinoscopic lymphadenectomy along the left recurrent laryngeal nerve. Ann Thorac Surg, 2015, 100(3): 1115-1117.
8. Fujiwara H, Shiozaki A, Konishi H, et al. Perioperative outcomes of single-port mediastinoscope-assisted transhiatal esophagectomy for thoracic esophageal cancer. Dis Esophagus, 2017, 30(10): 1-8.
9. Li GS. Prof. Qingdong Cao: single-port inflatable mediastinoscopy combined with laparoscopy for the radical treatment of esophageal cancer. J Thorac Dis, 2016, 8(9): E1108-E1109.
10. Wang X, Li X, Cheng H, et al. Single-port inflatable mediastinoscopy combined with laparoscopic-assisted small incision surgery for radical esophagectomy is an effective and safe treatment for esophageal cancer. J Gastrointest Surg, 2019, 23(8): 1533-1540.
11. Gan X, Wang X, Zhang B, et al. Lymphadenectomy along bilateral recurrent laryngeal nerves under single-incision mediastinoscopy. Ann Thorac Surg, 2020, 109(6): e449-e452.
12. Cuschieri A. Endoscopic subtotal oesophagectomy for cancer using the right thoracoscopic approach. Surg Oncol, 1993, 2(Suppl 1): 3-11.
13. Mariette C, Markar S, Dabakuyo-Yonli TS, et al. Health-related quality of life following hybrid minimally invasive versus open esophagectomy for patients with esophageal cancer, analysis of a multicenter, open-label, randomized phase Ⅲ controlled trial: The MIRO trial. Ann Surg, 2020, 271(6): 1023-1029.
14. Luketich JD, Pennathur A, Franchetti Y, et al. Minimally invasive esophagectomy: results of a prospective phase Ⅱmulticenter trial-the eastern cooperative oncology group (E2202) study. Ann Surg, 2015, 261(4): 702-707.
15. Biere SS, van Berge Henegouwen MI, Maas KW, et al. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet, 2012, 379(9829): 1887-1892.
16. Sakamoto T, Fujiogi M, Matsui H, et al. Comparing perioperative mortality and morbidity of minimally invasive esophagectomy versus open esophagectomy for esophageal cancer: A nationwide retrospective analysis. Ann Surg, 2019, Epub ahead of print.
17. Mamidanna R, Bottle A, Aylin P, et al. Short-term outcomes following open versus minimally invasive esophagectomy for cancer in England: a population-based national study. Ann Surg, 2012, 255(2): 197-203.
18. Moon DH, Lee JM, Jeon JH, et al. Clinical outcomes of video-assisted thoracoscopic surgery esophagectomy for esophageal cancer: a propensity score-matched analysis. J Thorac Dis, 2017, 9(9): 3005-3012.
19. Smithers BM, Gotley DC, Martin I, et al. Comparison of the outcomes between open and minimally invasive esophagectomy. Ann Surg, 2007, 245(2): 232-240.
20. Venissac N, Pop D, Mouroux J. Video-assisted mediastinoscopy as a therapeutic tool. Surg Endosc, 2009, 23(11): 2466-2472.
21. Wang QY, Tan LJ, Feng MX, et al. Video-assisted mediastinoscopic resection compared with video-assisted thoracoscopic surgery in patients with esophageal cancer. J Thorac Dis, 2014, 6(6): 663-667.
22. Bonavina L, Incarbone R, Bona D, et al. Esophagectomy via laparoscopy and transmediastinal endodissection. J Laparoendosc Adv Surg Tech A, 2004, 14(1): 13-16.

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Short-term follow-up results of inflatable mediastinoscopy combined with laparoscopy versus video-assisted thoracoscopic surgery combined with laparoscopy for esophageal cancer

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