66 SHORT-TERM RESULTS OF RADICAL SURGERY FOR ESOPHAGEAL CANCER WITHOUT THORACOTOMY

Abstract

Abstract In recent years, surgery without thoracotomy for esophageal cancer has been reported by performing mediastinoscope and laparoscope-assisted esophagectomy. It is reported that this procedure reduces pulmonary complications. Methods Since June 2018, we introduced this surgical operation for esophageal cancer patients using mediastinoscope without thoracotomy. The patient was placed in a supine position and tilts head slightly to the right with bilateral lung ventilation. The upper mediastinal dissection, using a left cervical approach, was performed with a single-port mediastinoscopic technique using LigaSure™ Maryland. But the lymph nodes along the right recurrent laryngeal nerve (RLN) were dissected under direct vision using a right cervical approach. And then, the operation and the course after the operation were examined. Results We experienced 14 cases of surgery by February 2020 and have experienced only one pulmonary complication in the course of the surgery. This case had a left recurrent nerve palsy as a complication after surgery. For this reason, aspiration was combined, but it improved immediately. There were 2 patients that lung cancer and COLD (Chronic Obstructive Pulmonary Disease), but pneumonia did not occur. Suture failure was very high frequent. However, this complication decreased over time. Conclusion We reported that pneumonia after esophageal cancer surgery deteriorates the prognosis. Suppression of pneumonia by this operation formula can be expected to improve the prognosis.