212. LAPARO-GASTROSCOPIC ESOPHAGECTOMY: A RETROSPECTIVE STUDY OF A PIONEER CASE SERIES

Abstract

Abstract Transcervical gastroscopic esophagectomy pioneered the gastroscope from intraluminal to extraluminal dissection for esophageal cancer. Its integration with laparoscopic gastric conduit formation, known as laparo-gastroscopic esophagectomy (LGE), was introduced an updated procedure of transhiatal esophagectomy. Herein, we report a case series to demonstrate its safety and efficacy. We began performing LGE in July 2020, and herein we retrospectively reviewed the results of primary cohort performed from July 2020 to September 2021, in which endoscopic sentinel lymph node (SLN) navigation, an addition to the LGE procedure, was performed on patients 6 to 11. Patient clinical features, operative outcomes and complications were collected and analyzed. The follow-up results of the cohort was recorded. LGE was successfully in 10 patients and 1 patient was excluded due to mucosal skip metastasis to cervical esophagus observed during SLN inspection. There were no intraoperative conversions or complications, and all patients tolerated the procedure well. Postoperatively, 2 patients developed pulmonary complications (One case of aspiration and 1 case of pleural effusion). SLNs were detected and removed in the last 4 cases, and frozen section examinations were negative. All patients were discharged within 10 days postoperatively, and no patient died at the latest follow-up in January 2022. Based on the primary cohort that received LGE, the procedure shows promising surgical results, and the addition of SLN will further guarantee the oncological efficacy.