Dataset Information

Larynx-preserving limited resection with total thoracic esophagectomy and gastric pull-up reconstruction: A promising treatment for selected cervical esophageal squamous cell carcinoma.

ABSTRACT:

Background/aims

There is no consensus on treatment for cervical esophageal squamous cell carcinoma (ESCC). Our aim is to evaluate the feasibility and outcome of larynx-preserving limited resection with total thoracic esophagectomy and gastric pull-up reconstruction for the treatment of cervical ESCC without tumor involvement of the larynx and hypopharynx.

Materials and methods

Retrospective analysis of patients with cervical ESCC who underwent R0 surgical resection from 2006 to 2011 in our center was performed. Kaplan-Meier method was used to calculate the survival time for patients.

Results

In total, 74 cervical ESCC patients were enrolled in the study. The mortality rate in 30 days was 8.1%, the total complication rate (at least one) was 47.3%, anastomosis leakage occurrence was 37.8%, mechanical ventilation ratewas12.2%, the rate of normal oral diet within 15 days was 71.6%, and the anastomosis recurrence rate in follow-up was 8.1%. Detailed analysis showed that the anastomosis leakage, pulmonary infection, laryngeal recurrent nerve injury, and chylothorax were the most common complications in surgical patients. Finally, the survival data showed that the median survival time was 31.83 months (95% CI=12.39-51.28 months) and the 3-year and 5-year survival rates were 49.1% and 35.5%, respectively.

Conclusion

Larynx-preserving limited resection with total thoracic esophagectomy and gastric pull-up reconstruction might be a feasible and effective surgical alternative for the cervical ESCC patients whose tumor does not involve the larynx and hypopharynx.

SUBMITTER: Wang WP

PROVIDER: S-EPMC7928245 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Larynx-preserving limited resection with total thoracic esophagectomy and gastric pull-up reconstruction: A promising treatment for selected cervical esophageal squamous cell carcinoma.

Wang Wu-Ping WP Ma Jie J Lu Qiang Q Han Yong Y Li Xiao-Fei XF Jiang Tao T Zhao Jin-Bo JB

The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology 20201201 12

<h4>Background/aims</h4>There is no consensus on treatment for cervical esophageal squamous cell carcinoma (ESCC). Our aim is to evaluate the feasibility and outcome of larynx-preserving limited resection with total thoracic esophagectomy and gastric pull-up reconstruction for the treatment of cervical ESCC without tumor involvement of the larynx and hypopharynx.<h4>Materials and methods</h4>Retrospective analysis of patients with cervical ESCC who underwent R0 surgical resection from 2006 to 20 ...[more]

PMID: 33626010

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Project description:Background:Robot-assisted minimally invasive esophagectomy (RAMIE) reduces postoperative respiratory complications and enables meticulous mediastinal lymphadenectomy. However, whether adding a robotic abdominal procedure to a robotic thoracic procedure can result in better outcomes is unclear. We examined outcomes after total-RAMIE (T-RAMIE) and compared them with the outcomes after hybrid-RAMIE (H-RAMIE). Methods:Total of 227 patients who underwent robotic esophagectomy for esophageal cancer were included. T-RAMIE was defined as esophagectomy performed robotically in both the thoracic and abdominal cavities. Laparotomy was used instead of the robotic procedure in H-RAMIE. T-RAMIE was performed in 144 patients (63.4%), and propensity score matching produced 49 matched pairs from each group. Early and long-term clinical outcomes between the two groups were compared. Results:T-RAMIE was mostly performed for upper or mid-thoracic squamous cell carcinoma (n=119, 82.6%) and cervical anastomosis, and three-field lymphadenectomy was performed in 113 (78.5%) and 54 (37.5%) patients, respectively. One laparotomy conversion was necessary because of severe obesity. The propensity-matched analysis demonstrated that T-RAMIE showed a comparable 90-day mortality rate with H-RAMIE (0% vs. 6.1%, P=0.083). The incidence rates of total (63.3% vs. 63.3%; P=1.000), abdominal (8.2% vs. 14.3%; P=0.366), and respiratory complications (10.2% vs. 10.2%; P=1.000) were not different between two groups. The number of harvested abdominal lymph nodes was similar (12.4±9.0 vs. 12.3±8.9; P=0.992). Median follow-up duration for T-RAMIE and H-RAMIE was 16.3 and 23.5 months, respectively. Two-year overall survival rate (86.2% in T-RAMIE vs. 77.6% in H-RAMIE; P=0.150) and recurrence-free survival (76.6% in T-RAMIE vs. 62.2% in H-RAMIE; P=0.280) were comparable between the two groups. Conclusions:In this matched analysis, T-RAMIE and H-RAMIE showed comparable early outcomes and long-term survival. The low tendencies of early mortality and conversion rate of T-RAMIE suggest that it might be a safe alternative to open stomach mobilization and abdominal lymphadenectomy.

Dataset Information

Larynx-preserving limited resection with total thoracic esophagectomy and gastric pull-up reconstruction: A promising treatment for selected cervical esophageal squamous cell carcinoma.

Background/aims

Materials and methods

Results

Conclusion

Publications

Larynx-preserving limited resection with total thoracic esophagectomy and gastric pull-up reconstruction: A promising treatment for selected cervical esophageal squamous cell carcinoma.

Similar Datasets

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