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SHORT-TERM OUTCOMES OF MINIMALLY INVASIVE ESOPHAGECTOMY WITH THREE FIELD LYMPH NODE DISSECTION IN TREATMENT OF ESOPHAGEAL CARCINOMA
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Abstract
Objectives: To assess the short-term outcomes of minimally invasive esophagectomy with three-field lymph node dissection in treatment of esophageal carcinoma at Hanoi Medical University Hospital. Methods: Retrospective descriptive study on 20 patients with esophageal squamous carcinoma undergoing minimally invasive esophagectomy with three field lymph node dissection. Results and discussion: The mean age was 59.75 ± 6.96. 100% was male. Tumor location: middle third 45%, lower third 55%. Staging: Among patients without neoadjuvant chemotherapy, 80% were at IB stage. Among patients on neoadjuvant chemotherapy, 40% were at stage I. Mean number of lymph nodes collected was 70,80±17,83. Patients with middle third esophageal cancer had a rate of cervical lymph node metastasis of 11,1% Middle third tumor patient group had higher rate of metastasis to thoracic lymph nodes, while lower third group had higher rate of abdominal lymph nodes. Complications were seen in 45% cases, with recurrent laryngeal nerve injury was the most common (35%), with all the injured nerve on the left, respiratory complications were witnessed in 25% cases. No intraoperative and postoperative mortality has been notified. Conclusion: Minimally invasive esophagectomy with three-field lymph node dissection is feasible in treatment of esophageal carcinoma. However, since the morbidity rate was high, the technique should only be performed in high-volume center, by experienced surgeons. More studies should be conducted with more patients and longer follow-up period to assess postoperative quality of life from this technique.
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Keywords
Esophageal cancer, three-field lymph node dissection
References
2. Otsuka K, Murakami M, Goto S, Ariyoshi T, Yamashita T, Saito A, et al. Minimally invasive esophagectomy and radical lymph node dissection without recurrent laryngeal nerve paralysis. Surg Endosc. 2020 Jun;34(6):2749–57.
3. Viet Trung Lam. Kết quả sớm của phẫu thuật cắt thực quản nội soi ngực bụng với nạo hạch 3 vùng điều trị ung thư thực quản. Y Học Thành Phố Hồ Chí Minh 2018;22(1):1; 2018.
4. Phạm Đức Huấn. Nghiên Cứu Điều Trị Phẫu Thuật Ung Thư Thực Quản Ngực. Luận Án Tiến Sĩ Học. 2003;
5. Nguyễn Xuân Hòa. Nghiên Cứu Ứng Dụng Phẫu Thuật Nội Soi Cắt Thực Quản và Nạo Vét Hạch Rộng Hai Vùng (Ngực - Bụng) Trong Điều Trị Ung Thư Thực Quản. Luận án Tiến sỹ y học. Trường Đại học Y Hà Nội; 2018.
6. Isono K, Sato H, Nakayama K. Results of a nationwide study on the three-field lymph node dissection of esophageal cancer. Oncology. 1991;48(5):411–20.
7. Nishihira T, Hirayama K, Mori S. A prospective randomized trial of extended cervical and superior mediastinal lymphadenectomy for carcinoma of the thoracic esophagus. Am J Surg. 1998 Jan;175(1):47–51.
8. Li B, Hu H, Zhang Y, Zhang J, Miao L, Ma L, et al. Three-field versus two-field lymphadenectomy in transthoracic oesophagectomy for oesophageal squamous cell carcinoma: short-term outcomes of a randomized clinical trial. Br J Surg. 2020 May;107(6):647–54.
9. Kato H, Watanabe H, Tachimori Y, Iizuka T. Evaluation of neck lymph node dissection for thoracic esophageal carcinoma. Ann Thorac Surg. 1991 Jun;51(6):931–5.
10. Ye K, Xu JH, Sun YF, Lin JA, Zheng ZG. Characteristics and clinical significance of lymph node metastases near the recurrent laryngeal nerve from thoracic esophageal carcinoma. Genet Mol Res GMR. 2014 Aug 25;13(3):6411–9.