微创食管切除术和根治性淋巴结清扫术，不伴喉返神经麻痹。
Minimally invasive esophagectomy and radical lymph node dissection without recurrent laryngeal nerve paralysis.
机构信息
Department of Surgery, Division of Gastroenterological and General Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
Department of Surgery, Jichi Medical University, Tochigi, Japan.
出版信息
Surg Endosc. 2020 Jun;34(6):2749-2757. doi: 10.1007/s00464-020-07372-3. Epub 2020 Feb 3.
Abstract
BACKGROUND
We introduce a novel operative technique to dissect lymph nodes adjacent to the recurrent laryngeal nerve, referred to as the "native tissue preservation" technique. Using this technique, there was no damage to the recurrent laryngeal nerve, which is maintained in its anatomical position.
METHODS
From September 2016 to December 2018, minimally invasive esophagectomy was performed in the left lateral decubitus position in 87 patients with esophageal cancer. The native tissue preservation technique for lymphadenectomy around the recurrent laryngeal nerve was used, and all patients were evaluated for recurrent laryngeal nerve paralysis.
RESULTS
Minimally invasive esophagectomy was completed in all patients without conversion to thoracotomy. Although an extended lymphadenectomy was performed in all patients, there were no grade II or higher complications (Clavien-Dindo classification) and no incidence of recurrent laryngeal nerve paralysis.
CONCLUSION
The native tissue preservation technique may reduce the incidence of recurrent laryngeal nerve paralysis after minimally invasive esophagectomy with radical lymph node dissection.
摘要
背景
我们介绍了一种新的手术技术，用于解剖与喉返神经相邻的淋巴结，称为“固有组织保护”技术。使用该技术，喉返神经没有受到损伤，保持在其解剖位置。
方法
自 2016 年 9 月至 2018 年 12 月，87 例食管癌患者采用左侧卧位行微创食管切除术。采用喉返神经周围淋巴结清扫的固有组织保护技术，所有患者均评估喉返神经麻痹。
结果
所有患者均完成微创食管切除术，无中转开胸。虽然所有患者均行扩大淋巴结清扫术，但无Ⅱ级及以上并发症（Clavien-Dindo 分级），无喉返神经麻痹发生。
结论
固有组织保护技术可能降低根治性淋巴结清扫微创食管切除术后喉返神经麻痹的发生率。
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