PS01.215: SUPERIOR MEDIASTINAL LYMPHADENECTOMY IN TOTALLY MINIMALLY INVASIVE OESOPHAGECTOMY FOR CANCER: CLINICAL AND ONCOLOGICAL OUTCOMES

Abstract

Abstract Background Minimally invasive oesophagectomy (MIO) is a challenging procedure associated with high rate of complications and mortality. The exact benefits of superior mediastinal lymphadenectomy (SML) have long been debated with no clear evidence pertaining to better outcomes for patients. With this study we aim to compare the short-term outcomes of MIOs that also underwent SML against the UK national average. Methods Thirty-nine consecutive patients underwent totally MIO under a surgical team from September 2016 to December 2017. SML included left and right paratracheal nodes (including the paratracheal retrocaval compartment) as well as the nodes along the left and right recurrent laryngeal nerves throughout their mediastinal course. Eligible patients had to have undergone SML during either a 3-stage or a 2-stage MIO. Comparisons of the following outcomes were made against the data released by the UK National Oesophago-Gastric Cancer Audit (NOGCA) 2017; anastomotic leak rate, chyle leak rate, 30-day mortality, 90-day mortality, length of stay (LOS), cardiac complications, respiratory complications, wound infection, unplanned surgery. Results Seven patients were identified as eligible according to the criteria. 30- and 90- day mortality was reduced in the participant group compared to national average (0% vs 1.9% and 0% vs 3.3% respectively). Wound infection and cardiac complications were also reduced in the participant group (0% vs 5.3% and 0% vs 2.8% respectively). There were no anastomotic or chyle leaks noted (vs National 3.8% and 6.3% respectively), but conversely rate of respiratory complications was considerably higher in our group (42.8% vs 16.9%). There was 1 right recurrent laryngeal nerve palsy noted. Median LOS was longer in the sample group (16 vs 12 days), with no reoperations (0 vs 10.2%). Median total lymph node count was 45 (IQR, 37–68), with median SML count being 8 (IQR, 5–22). Conclusion The small sample size is immediately recognised as a limiting and influencing factor in the results of this study. However MIOs with SML may provide some, although not comprehensive, benefit in oncological outcomes without adding any further significant morbidity. Larger studies are needed to assess the role SML can play in improving patient outcomes. Disclosure All authors have declared no conflicts of interest.