A comparative study on the clinical efficacy of inflatable mediastinoscopy syncrhonized laparoscopic esophagectomy with McKeown's technique

Abstract Background: Inflatable mediastinoscopy synchronous laparoscopic radical esophagectomy is not widely used domestically and internationally. In order to explore the technological innovation and application effects of inflatable mediastinoscopy synchronous laparoscopic radical esophagectomy, our team summarizes our surgical experience and hopes to further promote its application in clinical practice. Objective: To explore the technical innovation and application effect of inflatable mediastinoscope synchronous laparoscopic radical resection of esophageal cancer. Methods: From January 2017 to December 2018, 120 patients with esophageal cancer admitted by the same surgical team were retrospectively analyzed. A total of 64 patients were randomly divided into two groups: the experimental group with inflatable mediastinoscopy and the conventional group with McKeown (control group). Preoperative baseline data, perioperative index, postoperative index, near and long term survival rate and other indexes of patients in 2 groups were recorded, and statistical analysis was performed. Results: The operation was completed successfully in both groups. In the experimental group, the operation time was (116.26±43.34) min, the intraoperative blood loss was (33.28±19.78) ml, the lymph nodes were removed (32.77±2.23), and the hospital stay was (9.62±3.33) d. Esophagogastric anastomotic leakage occurred in 2 cases, recurrent laryngeal nerve injury in 1 case and chylous leakage in 1 case. All 120 patients were followed up until December 2023. None of the 120 cases had tumor recurrence and metastasis, and no death. Conclusion: Synchronous laparoscopic radical resection of esophageal cancer with inflatable mediastinoscope has no postoperative chest complications, shorter operation time, less pain and faster recovery. It can be used as a new supplement to the mainstream McKeown surgery for radical resection of esophageal cancer, and has a good development prospect. It is recommended to actively promote its application in clinical practice.