Bilateral transcervical mediastinoscopic-assisted transhiatal laparoscopic esophagectomy compared with thoracolaparoscopic esophagectomy for esophageal cancer: a propensity score-matched analysis
Background Transcervical mediastinoscopic esophagectomy for esophageal and esophagogastric junction cancer is indicated in select institutions because of the complex surgical technique required and the unfamiliar surgical view compared with the standard transthoracic esophagectomy approach. This stu...
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| creator | Daiko, Hiroyuki Ishiyama, Koshiro Kurita, Daisuke Kubo, Kentaro Kubo, Yuto Utsunomiya, Daichi Igaue, Shota Nozaki, Ryoko Akimoto, Eigo Kakuta, Ryuta Horonushi, Shotaro Fujita, Takeo Oguma, Junya |
| description | Background
Transcervical mediastinoscopic esophagectomy for esophageal and esophagogastric junction cancer is indicated in select institutions because of the complex surgical technique required and the unfamiliar surgical view compared with the standard transthoracic esophagectomy approach. This study was performed to compare the feasibility and efficacy of bilateral transcervical mediastinoscopic-assisted transhiatal laparoscopic esophagectomy (BTC-MATLE) with thoracolaparoscopic esophagectomy (TLE) for esophageal cancer.
Methods
This study involved 392 consecutive patients with esophageal cancer who underwent curative minimally invasive esophagectomy with R0 resection (excluding salvage, conversion, and two-stage operations and open thoracotomy) at the National Cancer Center Hospital from 2017 to 2022. The patients underwent either BTC-MATLE or TE (32 and 360 consecutive patients, respectively). Propensity score-matching analysis was used to balance the baseline differences by covariates of age, performance status, and clinical stage.
Results
There were statistically significant differences in age, performance status, cT factor, cN factor, cStage, preoperative treatment, and surgical history for respiratory disease. After propensity score-matching, these significant differences (excluding a surgical history of respiratory disease) were no longer statistically significant, and 27 patients were assigned to each group. The total operation time and the postoperative intensive care unit stay were significantly shorter in the BTC-MATLE than TLE group. There were no significant differences in overall postoperative complications or the three major postoperative complications of recurrent laryngeal nerve paralysis, anastomotic leakage, and pneumonia, even for patients whose preoperative pulmonary function indices (vital capacity and forced expiratory volume in 1 s) were significantly lower in the BTC-MATLE than TLE group. The numbers of total and thoracic harvested lymph nodes were significantly higher in the TLE than BTC-MATLE group; however, there was no significant difference in the recurrence rate between the two groups.
Conclusion
BTC-MATLE may provide the same feasibility and oncological outcomes as TLE even for patients with significantly lower pulmonary function. |
| doi_str_mv | 10.1007/s00464-024-11167-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3092872319</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3113886641</sourcerecordid><originalsourceid>FETCH-LOGICAL-c256t-607d067e7c351df05bc63dec72fc12aa6001059fefa1166b65abff158cbdc0b73</originalsourceid><addsrcrecordid>eNp9kc1u1TAQhS1ERS-FF2CBIrHpxtRjJ07CDir-pEpsYG1NHKdxlcTB9i26z9cXY0ouRWLRlWXPN8dH5zD2CsRbEKK-SEKUuuRClhwAdM3hCdtBqSSXEpqnbCdaJbis2_KUPU_pRhDfQvWMnaoWVKMb2LG7D37C7CJORY64JOvirbd0m13vMWW_hGTD6i3HlHzKrt-40WMmasIV45EoXArriNfO5jAfChtmmhH_y-exyGOIaMMj_BDiwwspW1zIy7sCizWG1S3J50NBi9HxGbMdSRgXnA5k6gU7GXBK7uXxPGM_Pn38fvmFX337_PXy_RW3stKZa1H3QteutqqCfhBVZ7Xqna3lYEEiaiFAVO3gBqQ0dacr7IYBqsZ2vRVdrc7Y-aZLjn7uXcpm9hTYNOHiwj4ZJVrZ1FJBS-ib_9CbsI_klyig7ButSyBKbpSlTFJ0g1mjnzEeDAhzX7HZKjZUsflTsblfen2U3ndU0sPK304JUBuQaLRcu_jv70dkfwOwhrk6</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3113886641</pqid></control><display><type>article</type><title>Bilateral transcervical mediastinoscopic-assisted transhiatal laparoscopic esophagectomy compared with thoracolaparoscopic esophagectomy for esophageal cancer: a propensity score-matched analysis</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Daiko, Hiroyuki ; Ishiyama, Koshiro ; Kurita, Daisuke ; Kubo, Kentaro ; Kubo, Yuto ; Utsunomiya, Daichi ; Igaue, Shota ; Nozaki, Ryoko ; Akimoto, Eigo ; Kakuta, Ryuta ; Horonushi, Shotaro ; Fujita, Takeo ; Oguma, Junya</creator><creatorcontrib>Daiko, Hiroyuki ; Ishiyama, Koshiro ; Kurita, Daisuke ; Kubo, Kentaro ; Kubo, Yuto ; Utsunomiya, Daichi ; Igaue, Shota ; Nozaki, Ryoko ; Akimoto, Eigo ; Kakuta, Ryuta ; Horonushi, Shotaro ; Fujita, Takeo ; Oguma, Junya</creatorcontrib><description>Background
Transcervical mediastinoscopic esophagectomy for esophageal and esophagogastric junction cancer is indicated in select institutions because of the complex surgical technique required and the unfamiliar surgical view compared with the standard transthoracic esophagectomy approach. This study was performed to compare the feasibility and efficacy of bilateral transcervical mediastinoscopic-assisted transhiatal laparoscopic esophagectomy (BTC-MATLE) with thoracolaparoscopic esophagectomy (TLE) for esophageal cancer.
Methods
This study involved 392 consecutive patients with esophageal cancer who underwent curative minimally invasive esophagectomy with R0 resection (excluding salvage, conversion, and two-stage operations and open thoracotomy) at the National Cancer Center Hospital from 2017 to 2022. The patients underwent either BTC-MATLE or TE (32 and 360 consecutive patients, respectively). Propensity score-matching analysis was used to balance the baseline differences by covariates of age, performance status, and clinical stage.
Results
There were statistically significant differences in age, performance status, cT factor, cN factor, cStage, preoperative treatment, and surgical history for respiratory disease. After propensity score-matching, these significant differences (excluding a surgical history of respiratory disease) were no longer statistically significant, and 27 patients were assigned to each group. The total operation time and the postoperative intensive care unit stay were significantly shorter in the BTC-MATLE than TLE group. There were no significant differences in overall postoperative complications or the three major postoperative complications of recurrent laryngeal nerve paralysis, anastomotic leakage, and pneumonia, even for patients whose preoperative pulmonary function indices (vital capacity and forced expiratory volume in 1 s) were significantly lower in the BTC-MATLE than TLE group. The numbers of total and thoracic harvested lymph nodes were significantly higher in the TLE than BTC-MATLE group; however, there was no significant difference in the recurrence rate between the two groups.
Conclusion
BTC-MATLE may provide the same feasibility and oncological outcomes as TLE even for patients with significantly lower pulmonary function.</description><identifier>ISSN: 0930-2794</identifier><identifier>ISSN: 1432-2218</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-024-11167-1</identifier><identifier>PMID: 39138681</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Aged ; Esophageal cancer ; Esophageal Neoplasms - surgery ; Esophagectomy - methods ; Feasibility Studies ; Female ; Gastroenterology ; Gynecology ; Hepatology ; Humans ; Laparoscopy ; Laparoscopy - methods ; Male ; Mediastinoscopy - methods ; Medicine ; Medicine & Public Health ; Middle Aged ; Operative Time ; Ostomy ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Proctology ; Propensity Score ; Respiratory diseases ; Retrospective Studies ; Surgery ; Surgical anastomosis ; Thoracoscopy - methods ; Treatment Outcome</subject><ispartof>Surgical endoscopy, 2024-10, Vol.38 (10), p.5746-5755</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-607d067e7c351df05bc63dec72fc12aa6001059fefa1166b65abff158cbdc0b73</cites><orcidid>0000-0002-9562-2966</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-024-11167-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-024-11167-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39138681$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Daiko, Hiroyuki</creatorcontrib><creatorcontrib>Ishiyama, Koshiro</creatorcontrib><creatorcontrib>Kurita, Daisuke</creatorcontrib><creatorcontrib>Kubo, Kentaro</creatorcontrib><creatorcontrib>Kubo, Yuto</creatorcontrib><creatorcontrib>Utsunomiya, Daichi</creatorcontrib><creatorcontrib>Igaue, Shota</creatorcontrib><creatorcontrib>Nozaki, Ryoko</creatorcontrib><creatorcontrib>Akimoto, Eigo</creatorcontrib><creatorcontrib>Kakuta, Ryuta</creatorcontrib><creatorcontrib>Horonushi, Shotaro</creatorcontrib><creatorcontrib>Fujita, Takeo</creatorcontrib><creatorcontrib>Oguma, Junya</creatorcontrib><title>Bilateral transcervical mediastinoscopic-assisted transhiatal laparoscopic esophagectomy compared with thoracolaparoscopic esophagectomy for esophageal cancer: a propensity score-matched analysis</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Transcervical mediastinoscopic esophagectomy for esophageal and esophagogastric junction cancer is indicated in select institutions because of the complex surgical technique required and the unfamiliar surgical view compared with the standard transthoracic esophagectomy approach. This study was performed to compare the feasibility and efficacy of bilateral transcervical mediastinoscopic-assisted transhiatal laparoscopic esophagectomy (BTC-MATLE) with thoracolaparoscopic esophagectomy (TLE) for esophageal cancer.
Methods
This study involved 392 consecutive patients with esophageal cancer who underwent curative minimally invasive esophagectomy with R0 resection (excluding salvage, conversion, and two-stage operations and open thoracotomy) at the National Cancer Center Hospital from 2017 to 2022. The patients underwent either BTC-MATLE or TE (32 and 360 consecutive patients, respectively). Propensity score-matching analysis was used to balance the baseline differences by covariates of age, performance status, and clinical stage.
Results
There were statistically significant differences in age, performance status, cT factor, cN factor, cStage, preoperative treatment, and surgical history for respiratory disease. After propensity score-matching, these significant differences (excluding a surgical history of respiratory disease) were no longer statistically significant, and 27 patients were assigned to each group. The total operation time and the postoperative intensive care unit stay were significantly shorter in the BTC-MATLE than TLE group. There were no significant differences in overall postoperative complications or the three major postoperative complications of recurrent laryngeal nerve paralysis, anastomotic leakage, and pneumonia, even for patients whose preoperative pulmonary function indices (vital capacity and forced expiratory volume in 1 s) were significantly lower in the BTC-MATLE than TLE group. The numbers of total and thoracic harvested lymph nodes were significantly higher in the TLE than BTC-MATLE group; however, there was no significant difference in the recurrence rate between the two groups.
Conclusion
BTC-MATLE may provide the same feasibility and oncological outcomes as TLE even for patients with significantly lower pulmonary function.</description><subject>Abdominal Surgery</subject><subject>Aged</subject><subject>Esophageal cancer</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Esophagectomy - methods</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Male</subject><subject>Mediastinoscopy - methods</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Operative Time</subject><subject>Ostomy</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Proctology</subject><subject>Propensity Score</subject><subject>Respiratory diseases</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical anastomosis</subject><subject>Thoracoscopy - methods</subject><subject>Treatment Outcome</subject><issn>0930-2794</issn><issn>1432-2218</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1TAQhS1ERS-FF2CBIrHpxtRjJ07CDir-pEpsYG1NHKdxlcTB9i26z9cXY0ouRWLRlWXPN8dH5zD2CsRbEKK-SEKUuuRClhwAdM3hCdtBqSSXEpqnbCdaJbis2_KUPU_pRhDfQvWMnaoWVKMb2LG7D37C7CJORY64JOvirbd0m13vMWW_hGTD6i3HlHzKrt-40WMmasIV45EoXArriNfO5jAfChtmmhH_y-exyGOIaMMj_BDiwwspW1zIy7sCizWG1S3J50NBi9HxGbMdSRgXnA5k6gU7GXBK7uXxPGM_Pn38fvmFX337_PXy_RW3stKZa1H3QteutqqCfhBVZ7Xqna3lYEEiaiFAVO3gBqQ0dacr7IYBqsZ2vRVdrc7Y-aZLjn7uXcpm9hTYNOHiwj4ZJVrZ1FJBS-ib_9CbsI_klyig7ButSyBKbpSlTFJ0g1mjnzEeDAhzX7HZKjZUsflTsblfen2U3ndU0sPK304JUBuQaLRcu_jv70dkfwOwhrk6</recordid><startdate>20241001</startdate><enddate>20241001</enddate><creator>Daiko, Hiroyuki</creator><creator>Ishiyama, Koshiro</creator><creator>Kurita, Daisuke</creator><creator>Kubo, Kentaro</creator><creator>Kubo, Yuto</creator><creator>Utsunomiya, Daichi</creator><creator>Igaue, Shota</creator><creator>Nozaki, Ryoko</creator><creator>Akimoto, Eigo</creator><creator>Kakuta, Ryuta</creator><creator>Horonushi, Shotaro</creator><creator>Fujita, Takeo</creator><creator>Oguma, Junya</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9562-2966</orcidid></search><sort><creationdate>20241001</creationdate><title>Bilateral transcervical mediastinoscopic-assisted transhiatal laparoscopic esophagectomy compared with thoracolaparoscopic esophagectomy for esophageal cancer: a propensity score-matched analysis</title><author>Daiko, Hiroyuki ; Ishiyama, Koshiro ; Kurita, Daisuke ; Kubo, Kentaro ; Kubo, Yuto ; Utsunomiya, Daichi ; Igaue, Shota ; Nozaki, Ryoko ; Akimoto, Eigo ; Kakuta, Ryuta ; Horonushi, Shotaro ; Fujita, Takeo ; Oguma, Junya</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-607d067e7c351df05bc63dec72fc12aa6001059fefa1166b65abff158cbdc0b73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal Surgery</topic><topic>Aged</topic><topic>Esophageal cancer</topic><topic>Esophageal Neoplasms - surgery</topic><topic>Esophagectomy - methods</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Male</topic><topic>Mediastinoscopy - methods</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Operative Time</topic><topic>Ostomy</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Proctology</topic><topic>Propensity Score</topic><topic>Respiratory diseases</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical anastomosis</topic><topic>Thoracoscopy - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Daiko, Hiroyuki</creatorcontrib><creatorcontrib>Ishiyama, Koshiro</creatorcontrib><creatorcontrib>Kurita, Daisuke</creatorcontrib><creatorcontrib>Kubo, Kentaro</creatorcontrib><creatorcontrib>Kubo, Yuto</creatorcontrib><creatorcontrib>Utsunomiya, Daichi</creatorcontrib><creatorcontrib>Igaue, Shota</creatorcontrib><creatorcontrib>Nozaki, Ryoko</creatorcontrib><creatorcontrib>Akimoto, Eigo</creatorcontrib><creatorcontrib>Kakuta, Ryuta</creatorcontrib><creatorcontrib>Horonushi, Shotaro</creatorcontrib><creatorcontrib>Fujita, Takeo</creatorcontrib><creatorcontrib>Oguma, Junya</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Daiko, Hiroyuki</au><au>Ishiyama, Koshiro</au><au>Kurita, Daisuke</au><au>Kubo, Kentaro</au><au>Kubo, Yuto</au><au>Utsunomiya, Daichi</au><au>Igaue, Shota</au><au>Nozaki, Ryoko</au><au>Akimoto, Eigo</au><au>Kakuta, Ryuta</au><au>Horonushi, Shotaro</au><au>Fujita, Takeo</au><au>Oguma, Junya</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bilateral transcervical mediastinoscopic-assisted transhiatal laparoscopic esophagectomy compared with thoracolaparoscopic esophagectomy for esophageal cancer: a propensity score-matched analysis</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2024-10-01</date><risdate>2024</risdate><volume>38</volume><issue>10</issue><spage>5746</spage><epage>5755</epage><pages>5746-5755</pages><issn>0930-2794</issn><issn>1432-2218</issn><eissn>1432-2218</eissn><abstract>Background
Transcervical mediastinoscopic esophagectomy for esophageal and esophagogastric junction cancer is indicated in select institutions because of the complex surgical technique required and the unfamiliar surgical view compared with the standard transthoracic esophagectomy approach. This study was performed to compare the feasibility and efficacy of bilateral transcervical mediastinoscopic-assisted transhiatal laparoscopic esophagectomy (BTC-MATLE) with thoracolaparoscopic esophagectomy (TLE) for esophageal cancer.
Methods
This study involved 392 consecutive patients with esophageal cancer who underwent curative minimally invasive esophagectomy with R0 resection (excluding salvage, conversion, and two-stage operations and open thoracotomy) at the National Cancer Center Hospital from 2017 to 2022. The patients underwent either BTC-MATLE or TE (32 and 360 consecutive patients, respectively). Propensity score-matching analysis was used to balance the baseline differences by covariates of age, performance status, and clinical stage.
Results
There were statistically significant differences in age, performance status, cT factor, cN factor, cStage, preoperative treatment, and surgical history for respiratory disease. After propensity score-matching, these significant differences (excluding a surgical history of respiratory disease) were no longer statistically significant, and 27 patients were assigned to each group. The total operation time and the postoperative intensive care unit stay were significantly shorter in the BTC-MATLE than TLE group. There were no significant differences in overall postoperative complications or the three major postoperative complications of recurrent laryngeal nerve paralysis, anastomotic leakage, and pneumonia, even for patients whose preoperative pulmonary function indices (vital capacity and forced expiratory volume in 1 s) were significantly lower in the BTC-MATLE than TLE group. The numbers of total and thoracic harvested lymph nodes were significantly higher in the TLE than BTC-MATLE group; however, there was no significant difference in the recurrence rate between the two groups.
Conclusion
BTC-MATLE may provide the same feasibility and oncological outcomes as TLE even for patients with significantly lower pulmonary function.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>39138681</pmid><doi>10.1007/s00464-024-11167-1</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-9562-2966</orcidid></addata></record> |
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| subjects | Abdominal Surgery Aged Esophageal cancer Esophageal Neoplasms - surgery Esophagectomy - methods Feasibility Studies Female Gastroenterology Gynecology Hepatology Humans Laparoscopy Laparoscopy - methods Male Mediastinoscopy - methods Medicine Medicine & Public Health Middle Aged Operative Time Ostomy Postoperative Complications - epidemiology Postoperative Complications - etiology Proctology Propensity Score Respiratory diseases Retrospective Studies Surgery Surgical anastomosis Thoracoscopy - methods Treatment Outcome |
| title | Bilateral transcervical mediastinoscopic-assisted transhiatal laparoscopic esophagectomy compared with thoracolaparoscopic esophagectomy for esophageal cancer: a propensity score-matched analysis |
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