Minimally Invasive Esophagectomy for Esophageal Squamous Cell Carcinoma: a Case-control Study of Thoracoscope Versus Mediastinoscope Assistance

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2011 Dec 20

PMID 22179461

Citations 23

Authors

Ming-Xiang Feng

Hao Wang

Yi Zhang

Li-Jie Tan

Zheng-Lang Xu

Wang Qun

Affiliations

Soon will be listed here.

Abstract

Objective: Minimally invasive esophagectomy (MIE) has been widely applied for esophageal carcinoma treatment. Thoracoscope-assisted transthoracic esophagectomy (TATTE) and mediastinoscope-assisted transhiatal esophagectomy (MATHE) are two kinds of MIE. The objective of this study is to compare these two methods with respect to surgical safety and survival.

Methods: Single-institution experience with MATHE and TATTE was analyzed to assess morbidity, adequacy of tumor clearance, and survival. A pair-matched case-control study was performed to compare 54 patients who underwent either MATHE or TATTE between July 2000 and December 2009. Patients were matched by age, sex, comorbidity, forced expiratory volume in 1 s (FEV1), tumor location, and stage.

Results: Statistically significant differences between the MATHE group and the TATTE group were: shorter operative time for MATHE (194.4 min) versus TATTE (228.1 min), less blood loss during operation in the TATTE group (142.6 ml) versus the MATHE group (214.6 ml), and more lymph nodes retrieved in the TATTE group (19.1 nodes) versus the MATHE group (11.4 nodes). There was no difference in survival between the groups.

Conclusions: MATHE and TATTE are both technically feasible. TATTE can provide better visibility. TATTE has less blood loss compared with MATHE. More adequate tumor clearance in terms of lymph node dissection can be achieved with TATTE.

Citing Articles

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Comparison of mediastinoscopy and thoracoscope minimally invasive esophagectomy in the treatment of esophageal cancer: a meta-analysis and system review.

Wang J, Zhao L, Lin J, Yu Y, Tong T, Zhao Y BMC Cancer. 2025; 25(1):14.

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Fang Y, Chen M, Zheng X, Yao Y, Huang K, Chen S Eur Radiol. 2024; .

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Song S, Shen C, Hu Y, He Y, Yuan Y, Xu Y Biomedicines. 2023; 11(10).

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Left-primary & right-auxiliary operation mode in mediastinoscope-assisted radical esophagectomy.

Yuan P, Hu W, Liu Z, Wu N, Lin H, Li S Surg Endosc. 2023; 37(10):7884-7892.

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