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Τετάρτη 17 Φεβρουαρίου 2021

A Standardized Procedure for Upper Mediastinal Lymph Node Dissection Improves the Safety and Efficacy of Robotic McKeown Esophagectomy

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ABSTRACT

Background

Recurrent laryngeal nerve (RLN) palsy is a common complication of upper mediastinal lymph node dissection (UMLND) in the context of esophageal cancer surgery. In an effort to reduce its occurrence, we developed a standardized surgical procedure that allows flexible suspension of the left RLN during robotic McKeown esophagectomy.

Patients and methods

Patients who received robotic McKeown esophagectomy for cancer were divided into two groups (pre‐ versus post‐standardization). Perioperative outcomes were retrospectively compared.

Results

The pre‐ and post‐standardization groups consisted of 44 and 42 patients, respectively. There were no significant intergroup differences in terms of number of dissected lymph nodes. Compared with the pre‐standardization group, patients treated after standardization had a markedly lowered incidence of left RLN palsy (20.5% versus 4.8%, respectively, p=0.029) and a reduced mean thoracic operating time (161.05 versus 131 min, respectively, p<0.001).

Conclusion

Our standardized surgical approach is efficient and may increase the safety of UMLND.

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