Application of Non-inflatable Mediastinoscopy Combined With Laparoscopic Radical Resection for Esophageal Cancer Patients With Concomitant Cardiovascular and Pulmonary Diseases
10.3969/j.issn.1009-6604.2025.08.003
- VernacularTitle:非充气式纵隔镜联合腹腔镜食管癌根治术在食管癌合并心肺疾病患者中的应用
- Author:
Yunsheng HUI
1
;
Binbin ZHANG
1
;
Nan JIANG
1
;
Rulin QIAN
1
Author Information
1. 河南省胸科医院 郑州大学附属胸科医院胸外科,郑州 450000
- Publication Type:Journal Article
- Keywords:
Non-inflatable mediastinoscopy;
Laparoscopy;
Radical resection of esophageal cancer;
Cardiovascular and pulmonary diseases
- From:
Chinese Journal of Minimally Invasive Surgery
2025;25(8):464-468
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical application value of non-inflatable mediastinoscopy combined with laparoscopic radical resection for esophageal cancer patients complicated with cardiovascular and pulmonary diseases.Methods A retrospective analysis was made on clinical data of 20 patients with esophageal cancer complicated with cardiovascular and pulmonary diseases treated with non-inflatable mediastinoscopy combined with laparoscopic radical resection in our hospital from January 2021 to October 2024.The cervical and abdominal surgical teams worked simultaneously.During the operation,a left neck incision was made to free the cervical esophagus.After inserting a mediastinoscope,an ultrasonic knife was used to free the thoracic esophagus from top to bottom and clean the lymph nodes adjacent to the esophagus.The laparoscopic procedure(freeing the stomach and esophagus from bottom to top)was connected in the mediastinum to complete the esophageal freedom,and a tubular stomach was made and anastomosed at the neck.Results All the 20 operations were successfully completed without conversion to thoracotomy.The operation time was(130.5±25.5)min,the intraoperative blood loss was(60.5±32.5)ml,a total of 3-11 mediastinal lymph nodes and1-5 abdominal lymph nodeswerecleared,andthe postoperative hospital stay was(20.0±6.0)d.There were 2 cases of anastomotic leakage,2 cases of anastomotic stenosis,2 cases of pleural effusion,2 cases of pulmonary infection,1 case of chylothorax,and 1 case of recurrent laryngeal nerve injury.After conservative treatment,all of which were cured.Postoperative pathology showed 18 cases of squamous cell carcinoma and 2 cases of adenocarcinoma.Postoperative TNM staging was 6 cases in stage Ⅰ,10 cases in stage Ⅱ,and 4 cases in stage Ⅲ,consistent with preoperative evaluation.All the20 cases were followed up for1-24 months,with a median follow-up time of 12 months.CT re-examinations showed no recurrence,and no death case was recorded.Conclusion Non-inflatable mediastinoscopy combined with laparoscopic radical resection is safe and feasible for esophageal cancer patients complicated with cardiovascular and pulmonary diseases.
