With the widespread application of minimally invasive esophagectomy, inflatable video-assisted mediastinoscopic transhiatal esophagectomy (IVMTE) has gradually become one of the alternative surgical methods for transthoracic esophagectomy due to less trama, fewer perioperative complications and better short-term efficacy. However, there is no uniform standard for surgical methods and lymph node dissection in medical centers that perform IVMTE, which affects the standardization and further promotion of IVMTE. Therefore, on the basis of fully consulting domestic and foreign literature, our team proposed an expert consensus focusing on IVMTE, in order to standardize the clinical practice, guarantee the quality of treatment and promote the development of IMVTE.
Objective To investigate the feasibility, safety, and short-term efficacy of minimally invasive McKeown esophagectomy (MIME) in patients with locally advanced thoracic esophageal squamous cell carcinoma (TESCC) after neoadjuvant immunotherapy. Methods The clinical data of the patients with locally advanced TESCC in the First Affiliated Hospital of University of Science and Technology of China from July 2022 to March 2023 were restrospectively analyzed. There were divided into a neoadjuvant immunotherapy (NI) group and a non neoadjuvant immunotherapy (NNI) group according to different preoperative neoadjuvant therapy. The clinicopathologic factors, preoperative adjuvant therapy, surgery-related indicators, postoperative complications were compared between the two groups.Results A total of 47 patients were collected, including 31 males and 16 females with a mean age of 67.57±7.64 years. There were 29 patients in the NI group and 18 patients in the NNI group. The two groups were similar in terms of age, sex, tumor location, preoperative staging, combination treatment regimens, grade of differentiation, history of smoking and drinking and preoperative complications(P＞0.05). There was no statistical difference in the operative duration, blood loss, the total hospital costs, hospital stays, postoperative complications, pTNM stages, the number of lymph nodes dissected and the number of stations of NI group and NNI group (P＞0.05). Conclusion Neoadjuvant immunotherapy combined with minimally invasive McKeown esophagectomy can be safely and effectively performed for patients with locally advanced TESCC without increasing operation time, intraoperative blood loss and perioperative complications.