Minimally invasive esophagectomy and radical lymph node dissection without recurrent laryngeal nerve paralysis.

Abstract

BACKGROUND:

We introduce a novel operative technique to dissect lymph nodes adjacent to the recurrent laryngeal nerve, referred to as the "native tissue preservation" technique. Using this technique, there was no damage to the recurrent laryngeal nerve, which is maintained in its anatomical position.

METHODS:

From September 2016 to December 2018, minimally invasive esophagectomy was performed in the left lateral decubitus position in 87 patients with esophageal cancer. The native tissue preservation technique for lymphadenectomy around the recurrent laryngeal nerve was used, and all patients were evaluated for recurrent laryngeal nerve paralysis.

RESULTS:

Minimally invasive esophagectomy was completed in all patients without conversion to thoracotomy. Although an extended lymphadenectomy was performed in all patients, there were no grade II or higher complications (Clavien-Dindo classification) and no incidence of recurrent laryngeal nerve paralysis.

CONCLUSION:

The native tissue preservation technique may reduce the incidence of recurrent laryngeal nerve paralysis after minimally invasive esophagectomy with radical lymph node dissection.

• Authors: Koji Otsuka, Masahiko Murakami, Satoru Goto, Tomotake Ariyoshi, Takeshi Yamashita, Akira Saito, Masahiro Kohmoto, Rei Kato, Alan Kawarai Lefor, Takeshi Aoki
• Journal: Surgical endoscopy (Surg Endosc) Vol. 34 Issue 6 Pg. 2749-2757 (06 2020) ISSN: 1432-2218 [Electronic] Germany
• PMID: 32016515 (Publication Type: Journal Article)

Topics

• Esophageal Neoplasms (surgery)
• Esophagectomy (adverse effects, methods)
• Female
• Humans
• Incidence
• Lymph Node Excision (adverse effects, methods)
• Lymph Nodes (pathology, surgery)
• Male
• Middle Aged
• Postoperative Complications (epidemiology, etiology)
• Recurrent Laryngeal Nerve (pathology, surgery)
• Recurrent Laryngeal Nerve Injuries (epidemiology, etiology)
• Vocal Cord Paralysis (epidemiology, etiology)