216. SHORT-TERM OUTCOMES OF 111 CASES OF MEDIASTINOSCOPIC ESOPHAGECTOMY FOR ALL ESOPHAGEAL CANCERS

Abstract

Abstract Background Mediastinoscopic esophagectomy (ME) as a radical surgery for esophageal cancer is considered promising because of its low complication rate of pneumonia. In our hospital, ME with three-field lymphadenectomy is the first choice for radical esophagectomy and is indicated for all cases of esophageal cancer, including borderline resectable, locally invasive tumors, conversion surgery, and salvage surgery. However, there have been few reports of ME for highly advanced esophageal cancer, and its safety and feasibility are unknown. Methods From April 2018 to April 2023, we retrospectively investigated all cases of radical esophagectomy at our hospital. Patient characteristics and perioperative short-term outcomes were investigated. Results cStage 0/I/II/III/IV were 7/20/26/37/21 respectively. 70% of patients were treated with neoadjuvant chemotherapy. ME was performed in 111 cases, thoracoscopy and thoracotomy in 0 cases. The conversion rate from ME to thoracotomy was 0.9%. The mean operation time was 547 min and blood loss was 215 mL. Postoperative complications of classified as grade II in the CD classification occurred in 19.8%, and more than grade IIIa occurred in 13.5%. The mean postoperative hospital stay was 20 days. The number of dissected lymph nodes was 47. The completion rate of R0 surgery was 94%. Conclusion ME for all esophageal cancers, including borderline resectable tumors and locally invasive tumors, was safe and feasible. ME with three-field lymphadenectomy may be the first choice for radical esophagectomy.