WANG Jiao 1 , ZHU Ziyin 2 , YAO Shuhuan 2 , SUN Xiang 2 , ZHANG Haifeng 1 , HU Baoli 1 , WEI Haitao 1 , LI Li 1,2 , ZHANG Hui 3
  • 1. Department of Thoracic Surgery, Huaihe Hospital, Henan University, Kaifeng, 475001, Henan, P. R. China;
  • 2. College of Nursing and Health, Henan University, Kaifeng, 475001, Henan, P. R. China;
  • 3. Department of Gastroenterology, Huaihe Hospital, Henan University, Kaifeng, 475001, Henan, P. R. China;
LI Li, Email: 10210051@vip.henu.edu.cn; ZHANG Hui, Email: zzy111@henu.edu.cn
Synchronized laparoscopic inflatable mediastinoscopy; inflatable video-assisted mediastinoscopic transhiatal esophagectomy; radical resection of esophageal carcinoma; comparative study
10.7507/1007-4848.202504101
Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables References Cited by

Objective  To compare the differences in postoperative pulmonary function and quality of life between synchronous and combined mediastinoscopy with laparoscopic radical resection of esophageal cancer, providing evidence for selecting the optimal surgical approach. Methods  A retrospective analysis was conducted on patients who underwent minimally invasive mediastinoscopic esophagectomy at Huaihe Hospital of Henan University from January 2023 to January 2025. Patients were divided into two groups based on surgical approach: the synchronized laparoscopic inflatable mediastinoscopy (SPIMSLE) group and the inflatable video-assisted mediastinoscopic transhiatal esophagectomy (IVMTE) group. Propensity score matching (1 : 1) was applied to balance baseline characteristics. Perioperative indicators, pulmonary function (FEV1, FVC, FEV1/FVC ratio), postoperative complications, pain levels (NRS score), and quality of life were statistically analyzed. Results  A total of 173 patients were enrolled, including 110 males, 63 females with a mean age of (62.5±6.2) years. After matching, each group comprised 80 patients. No significant differences were observed in gender, age, tumor location, or clinical stage (all P>0.05). The SPIMSLE group demonstrated superior outcomes: shorter operative time [(100.32±15.28) vs. (134.53±16.43) min, P<0.001], less intraoperative blood loss [(40.13±12.73) mL vs. (69.45±12.34) mL, P<0.001), and shorter postoperative hospitalization [(10.50±2.00) d vs. (12.50±2.50) d, P<0.001]. At 1-6 months postoperatively, the SPIMSLE group showed faster recovery in pulmonary function (FEV1, FVC, FEV1/FVC ratio, P<0.05), lower complication rates (16.25% vs. 40%, P<0.001), reduced pain (NRS score, P<0.05), and improved quality of life (P<0.05). No significant difference was noted in lymph node dissection (P>0.05). All patients were followed up until June 2025, with no recurrence, metastasis, or mortality among the 160 cases. Conclusion  Compared to IVMTE, SPIMSLE offers shorter operative time, reduced blood loss, faster pulmonary recovery, fewer complications, milder pain, and better quality of life, demonstrating significant clinical advantages.

Copyright © the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved