scholarly journals Achieving adequate lymph node dissection in treating esophageal squamous cell carcinomas by radical lymphadenectomy: Beyond the scope of numbers of harvested lymph nodes

2019 ◽  
Author(s):  
Zheng Lin ◽  
Weilin Chen ◽  
Yuanmei Chen ◽  
Xiane Peng ◽  
Siyou Yan ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Squamous Cell ◽  
Squamous Cell Carcinomas ◽  
Node Dissection ◽  
Radical Lymphadenectomy ◽  
Esophageal Squamous Cell Carcinomas ◽  
Adequate Lymph Node

PS02.004: THE FEASIBILITY AND EFFECTIVENESS OF ‘TOTAL ENDOSCOPIC 2.5 FIELD LYMPH NODE DISSECTION’ IN TREATMENT OF THORACIC ESOPHAGEAL SQUAMOUS CELL CARCINOMA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 120-121
Author(s):  
Bin Zheng ◽  
Ruopeng Hong ◽  
Shuliang Zhang ◽  
Taidui Zeng ◽  
Hao Chen ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Esophageal Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Lymph Node Dissection ◽  
Squamous Cell ◽  
Node Dissection ◽  
Recurrent Laryngeal Nerves ◽  
The Right

Abstract Background Due to the difficulty of dissection, surgical trauma, postoperative complications and other factors, the promotion of 3-field lymph node dissection is subject to certain restrictions. We try to explore and summarize a method of lymph node dissection, ‘endoscopic 2.5 lymph node dissection ’, that is, thoracoscopy combined with laparoscopic radical abdominal field, chest field and lower cervical paraesophageal lymph nodes (including 101 group below thyroid artery). Methods Retrospective analysis of 240 patients with thoracic esophageal squamous cell carcinoma from November 1, 2015 to December 31, 2017. All patients underwent endoscopic 2.5-field lymphadenectomy. The average age is (58.2 ± 9.5) years old. During the thoracoscopic part, when we do the lymphadenectomy along recurrent laryngeal nerves in the upper mediastimun and lower neck, we used a combination of ‘esophageal suspension method’, ‘lymph node rolling dissection method’ and ‘multi-angle pulling method’ to reveal the lymph nodes (Figure 1). Surgical related factors were collected and analyzed. Continuous follow-up was performed to record the recurrence and metastasis of patients and postoperative survival. Results Lymphadenectomy level of the right recurrent laryngeal nerve could reach the level above the right inferior thyroid artery, and the left could reach the level of 101 station. All operations were successfully completed. The incidence of pulmonary infection was 11.7%, the incidence of anastomotic leakage was 1.3%, the hoarseness rate was 7.9% and the incidence of chylothorax was 4.2%. The average number of total, abdominal and thoracic lymph nodes dissected were higher than the number of guidelines requirement and most of the previous literature. The average postoperative hospital stay was 8.4 days. The local recurrence rate, metastasis rate and survival rate of all the patients were not inferior to those reported in the past. Conclusion In patients with thoracic esophageal squamous cell carcinoma, the use of ‘total endoscopic 2.5-field lymph noede dissection’, could expand the range of lymph node dissection, and reached the super-thoracic and lower cervical level, which is beneficial to improve the degree of dissection along the recurrent laryngeal nerves. The procedure is safe and feasible, the results of short-term follow-up results are good, and it is worth further promotion. Disclosure All authors have declared no conflicts of interest.

P221 THE ROLE OF SUBCARINAL LYMPH NODE DISSECTION IN ESOPHAGECTOMY - A 5-YEAR SINGLE CENTER EXPERIENCE

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Eustratia Mpaili ◽  
Dimitrios Schizas ◽  
Maria Mpoura ◽  
Ilias Vagios ◽  
Constantinos Zografos ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Squamous Cell ◽  
Cell Cancer ◽  
Gastroesophageal Junction ◽  
Neoadjuvant Treatment ◽  
Node Dissection ◽  
Subcarinal Lymph Node

Abstract Aim To evaluate the involvement of subcarinal lymph node dissection (SLND) in the surgical treatment of esophageal cancer, as well as its impact on surgical outcomes following esophagectomy. Background & Methods Data on patients that underwent esophagectomy from 01/03/2014 to 01/03/2019 were prospectively collected and retrospectively reviewed. Based on the medical records, the following parameters were collected and analyzed: patient demographics, histopathological parameters, surgical- oncological outcomes. All patients were staged according to the AJCC 8th edition. Results A total of 79 patients underwent Ivor Lewis or McKeown esophagectomy for either squamous cell carcinoma (n= 7 patients) or adenocarcinoma of the esophagus or gastroesophageal junction (n= 72 patients). In 26 cases, esophagectomy was performed without SLND, while 53 cases underwent SLND. Among the 53 patients, 50 (94.3%) were men, and 3 (5.7 %) were women. Mean age was 61.4 years, (range 34-78). Mean nodal harvest was 34.7 lymph nodes per patient. Lymph node invasion was noted in 33 patients (62.2%), with a mean of 9 positive lymph nodes per patient. Subcarinal lymph nodes were involved in 5 out of 53 patients (9.4%). The ratio of positive subcarinal lymph nodes to resected ones was 1/2 (50%), 3/3 (100%), 1/2 (50%), 1/2 (50%) and 1/1 (100%) for each patient. Final histopathological report showed adenocarcinoma of moderate or poor differentiation (G2 2/5, G3 3/5) in all five patients (100%). Four out of 5 patients had not received neoadjuvant treatment and their pathological staging was T3N3M0. One patient had received neoadjuvant chemotherapy and his final staging was ypT3N2M0. Noteworthy, the seven patients diagnosed with squamous carcinoma, were subjected to SLND and were 100% negative for invasion histologically. Conclusion Subcarinal lymph nodes were infiltrated in 9.4% of patients operated for esophageal cancer. In the squamous cell cancer group, the relative infiltration rate was notably 0%. It seems that omission of subcarinal lymph node dissection during transthoracic esophagectomy cannot be justified.

PS02.009: APPLICATION OF SINGLE-PORT VIDEO-ASSISTED THORACOSCOPE IN TREATING THORACIC ESOPHAGEAL SQUAMOUS CELL CARCINOMA USING MCKEOWN APPROACH

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 122-123
Author(s):  
Qiang Lv
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Esophageal Squamous Cell Carcinoma ◽  
Minimally Invasive ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Lymph Node Dissection ◽  
Squamous Cell ◽  
Thoracic Segment ◽  
Node Dissection

Abstract Background Early radical resections are the main treatment methods towards esophageal squamous cell carcinoma (ESCC). Classic transthoracic esophagectomy (McKeown approach) could resect esophagus lesion as a whole piece, so the surgical results could be satisfactory and the regional lymph node dissection could be clean. With the maturation of video-assisted thoracoscope in thoracic surgeries, good vision, subtle operating system, and mature operating technologies have made the multi-portal thoracoscopic minimally invasive laparoscopic esophageal resection more and more mature. Meanwhile, SPVATS gradually appeared, which was firstly used in simple thoracic surgeries, and further applied to lung and mediastinal tumor resection; relevant summaries have been reported, and the feasibility of SPVATS for standard mediastinal lymph node dissection was also further verified.The application of SPVATS towards TESCC has also been gradually carried out. Would minimally invasive esophagectomy be safe? Whether SPVATS could be used in the McKeown approach for TESCC? Whether SPVATS could safely resect esophagus, and perform standard dissection towards local esophageal region and mediastinal lymph nodes, as well as avoid damaging the surrounding organs and tissues? Some scholars had compared SPVATS and multi-portal VATS in treating medio-inferior TESCC. Methods METHODS: 25 McKeown approach-based SPVATS surgeries (19 males and 6 females, aged 42–70years) were carried out from January 2015 to December 2017 to treat TESCC, including 2 case in upper thoracic segment, 15 cases in median thoracic segment, and 8 cases in inferior thoracic segment. All the cases were pathologically diagnosed as SCC preoperatively. SPVATS was performed to free thoracic esophagus and dissect the lymph nodes, and laparoscopy was performed to free stomach and to perform esophagus-left gastric collum anastomosis. Results RESULTS: All the patients were successfully completed SPVATS, with average thoracic surgery time as 150 min, intraoperative blood loss as 30–260 ml (average 90 ml), and postoperative hospital stay as 9–16d (average 12d). Conclusion CONCLUSIONS: SPVATS was technically feasible and safe in treating TESCC using McKeown approach, with less trauma and rapid postoperative recovery, so it could be used as a new surgical option for McKeown approach-based TESCC treatment. Disclosure All authors have declared no conflicts of interest.

Standard Lymph Node Dissection for Bladder Cancer: Significant Variability in the Number of Reported Lymph Nodes

2012 ◽  
Vol 187 (2) ◽  
pp. 446-450 ◽  
Author(s):  
R.P.P. Meijer ◽  
C.J.M. Nunnink ◽  
A.E. Wassenaar ◽  
A. Bex ◽  
H.G. van der Poel ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Significant Variability

Laparoscopic detection of sentinel lymph nodes followed by lymph node dissection in patients with early stage cervical cancer

2003 ◽  
Vol 90 (2) ◽  
pp. 290-296 ◽  
Author(s):  
Marrije R Buist ◽  
Rik J Pijpers ◽  
Arthur van Lingen ◽  
Paul J van Diest ◽  
Jan Dijkstra ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Early Stage ◽  
Sentinel Lymph Nodes ◽  
Node Dissection ◽  
Early Stage Cervical Cancer
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