120 LYMPHADENECTOMY ALONG THE LEFT RECURRENT LARYNGEAL NERVE AFTER ESOPHAGEAL STRIPPING

• Published in: Diseases of the esophagus Vol. 33; no. Supplement_1
• Main Authors: Makino, H, Nomura, S, Maruyama, H, Yokoyama, T, Hirakata, A, Takata, H, Kogo, H, Iwai, T, Yoshioka, M, Yoshida, H
• Format: Journal Article
• Language: English
• Published: 14.09.2020
• ISSN: 1120-8694; 1442-2050
• DOI: 10.1093/dote/doaa087.22

Abstract   The working space in the upper mediastinum is limited and lymphadenectomy along the left recurrent laryngeal nerve is difficult and anastomosis by a circular stapler in the narrow neck field is also difficult in VATS-E. We report our technique of the lymphadenectomy along the left recurrent laryngeal nerve. Methods (1) Patients. One hundred forty seven patients with esophageal carcinomas underwent VATS-E. (2) Methods. i) VATS-E in prone position. Esophagectomy is performed in prone position with 5 ports those are used at the intercostal space (ICS) and pneumothorax by maintaining CO2 insufflation. ii) Lymphadenectomy around left recurrent laryngeal nerve. Working space at the left upper mediastinal area for lymphadenectomy around the recurrent laryngeal nerve is limited in prone position. To obtain the space the residual esophagus is stripped in the reverse direction and retracted toward the neck after the stomach tube is removed through the nose. Results 1. The rate of permanent and transient recurrent laryngeal nerve paralysis were 2.6% and 20%, respectively. 2. The rate of anastomotic leak and postoperative pneumonia was 3.9% and 2.9%. Conclusion Lymphadenectomy along the left recurrent laryngeal nerve after esophageal stripping is available in prone position of VATS-E.