Evaluation of Mediastinal Lymphadenectomy by Minithoracotomy Assisted Thoracoscopic Esophagectomy for Esophageal Cancer

Masashi Takemura, Harushi Osugi, Taigo Tokuhara, Nobuyasu Takada, Hiroaki Kinoshita and Masayuki Higashino^*

Second Department of Surgery, Osaka City University Medical School
^*Department of Gastoroenterological Surgery, Osaka City General Hospital

The capability of minithoracotomy assisted thoracoscopic esophagectomy as a curative procedure for esophageal cancer was compared with conventional esophagectomy through right thoracotomy by the quality of mediastinal lymph node dissection. Of the patients with esophageal cancer who were treated with minithoracotomy assisted thoracoscopic esophagectomy from July 1995 to July 1998, 39 patients, excluding the patients who were converted to conventional thoracotomy and ended in noncurative operation, were classified as T group. Fifty-three patients who underwent conventional esophagectomy through right thoracotomy and who were not resected of other extraesophageal organs from January 1993 to June 1995 were classified as C group. No hospital death were occurred in either group. No significant difference in the frequency of postoperative complications was found. Although the operative stage was different, the pathological stage was not different in two groups. The duration of thoracic procedure was significantly longer in T group than in the C group. No significant difference was observed in the mount of intrathoracic blood loss. The number of dissected nodes and metastatic nodes in the mediastinum was not different between two groups. Regarding location of lymph node including tracheobronchial nodes and nodes along the recurrent laryngeal nerves, no difference was found. These results suggests that minithoracotomy assisted thoracoscopic esophagectomy is efficacious as a curative procedure for esophageal cancer.

Key words
thoracoscopic esophagectomy, mediastinal lymph node dissection, minithoracotomy

Reprint requests
Masashi Takemura Second Department of Surgery, Osaka City University Medical School 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585 JAPAN

Accepted
March 31, 1999

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