182. LAPAROSCOPIC-ASSISTED SINGLE-PORT MEDIASTINOSCOPIC ESOPHAGECTOMY CAN PROVIDE A SAFE AND EFFECTIVE SURGICAL OPTION FOR PATIENTS WITH SPECIFIC ESOPHAGEAL CANCERS

Abstract The majority of traditional minimally invasive esophagectomies are transthoracic esophagectomies. However, transthoracic esophagectomy is often difficult to perform in some patients with pulmonary insufficiency, severe pleural adhesions, chest deformities, and poor tolerance for single-lung ventilation. For this reason, we propose laparoscopic-assisted single-port mediastinoscopic esophagectomy as a potential surgical treatment for patients who are unsuitable for transthoracic esophagectomy. The goal of this study was to report the effectiveness and safety of its treatment. This study retrospectively collected clinical data from hard-to-reach transthoracic patients who underwent laparoscopic-assisted single-port mediastinoscopic esophagectomy at our center from October 2016 to August 2021 to report their perioperative treatment outcomes. Data for continuous variables are expressed as mean ± standard deviation, and categorical variables are expressed as n [%]. All data were analyzed using SPSS 25.0 software. A total of 8 cases were included and all completed the surgery successfully. The average operating time was 266.14 min, the average intraoperative bleeding was 114.29 mL, the average number of lymph nodes obtained was 13.29, the average number of recurrent laryngeal nerve (RLN) lymph nodes was 3.14, the rate of RLN lymph nodes obtained was 75%, the average postoperative hospital stay was 22.29 days. Postoperative complications included type I vocal cord paralysis [37.5%], anastomotic leak [25%], pneumonia [12.5%], pleural effusion [25%], and type I Chyle Leak [12.5%], with no perioperative deaths. There was one recurrence and no death within 1 year postoperatively. The results of this study suggest that laparoscopic-assisted single-port mediastinoscopic esophagectomy can provide a safe and effective treatment option for patients with esophageal cancer who have difficulty undergoing transthoracic esophagectomy and can achieve a more satisfactory short-term survival outcome.