Premium
A standardized procedure for upper mediastinal lymph node dissection improves the safety and efficacy of robotic McKeown oesophagectomy
Author(s) -
Chao YinKai,
Tsai ChunYi,
Illias Amina M.,
Chen ChunYu,
Chiu ChienHung,
Chuang WenYu
Publication year - 2021
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.2244
Subject(s) - medicine , dissection (medical) , perioperative , surgery , lymph node , context (archaeology) , mediastinal lymph node , recurrent laryngeal nerve , esophageal cancer , palsy , esophagectomy , mediastinum , lymph , cancer , paleontology , alternative medicine , thyroid , pathology , biology , metastasis , psychiatry
Background Recurrent laryngeal nerve (RLN) palsy is a common complication of upper mediastinal lymph node dissection (UMLND) in the context of oesophageal cancer surgery. In an effort to reduce its occurrence, we developed a standardised surgical procedure that allows flexible suspension of the left RLN during robotic McKeown oesophagectomy. Patients and methods Patients who received robotic McKeown oesophagectomy for cancer were divided into two groups (pre and poststandardisation). Perioperative outcomes were retrospectively compared. Results The pre and poststandardisation 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 prestandardisation group, patients treated after standardisation had a markedly lowered incidence of left RLN palsy (20.5% vs. 4.8%, respectively, p = 0.029) and a reduced mean thoracic operating time (161.05 vs. 131 min, respectively, p < 0.001). Conclusion Our standardised surgical approach is efficient and may increase the safety of UMLND.