ISSN: 1859 - 2872
Technical characteristics of video-assisted transthoracic esophagectomy with substernal gastric tube for the treatment of esophageal cancer
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Abstract
Objective: To study the technical characteristics, feasibility, and safety of video-assisted transthoracic esophagectomy with the substernal gastric tube in the treatment of esophageal cancer at 108 Military Central Hospital. Subject and method: A retrospective and prospective study, including 77 patients in middle and lower thirds who underwent video-assisted transthoracic esophagectomy with the substernal gastric tube from November 2018 to November 2022. The technical parameters of surgery were recorded and analyzed using SPSS 17.0 software. Result: Mean age was 57.49 ± 7.89 years. 100% of patients were male. 57.15% used a single endotracheal tube. The group using the single endotracheal tube had a significantly higher number of lymph nodes removed and the number of lymph nodes along the left recurrent laryngeal nerve than that using a double endotracheal tube. 64.9% of patients used a large gastric tube. The majority of patients used 2 staplers and 3 staplers (89.6%). There were 10.4% of patients who received stitches to enhance the cutting area. There were no cases of bleeding at stapler line and gastric tube leakage. The majority of patients who made anastomosis using a circular stapler (70.1%). The cases of placing anastomosis above the sternal notch accounted for a high rate (76.6%). The majority of patients (87%) had laparoscopic substernal tunneling. 7.8% of patients identified the wrong place to enter the tunnel entrance. The wrong direction of the tunnel was 13%. 12.98% of patients had complications when creating the tunnel, of which: 5.2% were pleural tears, 2.6% were pericardial tears, 3.9% were minor bleeding, and 1.3% were tunnel was not wide enough. Conclusion: The video-assisted transthoracic esophagectomy with substernal gastric tube is feasible, safe, and has a low rate of complications when creating the tunnel.
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References
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