Abstract：
The McKeown minimally invasive esophagectomy (McMIE) procedure has various limitations, including surgical contraindications and a high rate of postoperative pulmonary complications. A novel mediastinoscopic esophagectomy procedure was described in this study by using esophageal invagination and a transhiatal and bilateral cervical approach (EITHBC).
According to the mode of operation, a total of 259 patients were divided into two groups, among which 106 underwent EITHBC and 153 underwent McMIE. The number of lymph nodes dissected, intraoperative outcomes, and postoperative outcomes were compared between the two groups of patients.
The results revealed that the average number of resected lymph node in the EITHBC group was significantly higher in the recL106 and TbL106 stations (recL106: 1.75 vs. 1.51, p = 0.016, TbL106: 1.53 vs. 1.19, p = 0.016) and significantly lower in the 107 stations (1. 74 vs. 2. 07, p < 0.001) than in the McMIE group. The intraoperative blood loss in the EITHBC group was significantly lower than that in the McMIE group (63.30 vs. 80.45 mL, p < 0.001). The incidence of postoperative pulmonary complications in the EITHBC group was lower than that in the McMIE group (14.15% vs. 27.45%, p = 0.008). The incidence of recurrent laryngeal nerve paralysis in the EITHBC group was significantly higher than that in the McMIE group (26.41% vs. 10.46%, p = 0.003).
Compared with the McMIE procedure, the EITHBC procedure has advantages in terms of removing the upper mediastinal lymph nodes and reducing postoperative pulmonary complications.
According to the mode of operation, a total of 259 patients were divided into two groups, among which 106 underwent EITHBC and 153 underwent McMIE. The number of lymph nodes dissected, intraoperative outcomes, and postoperative outcomes were compared between the two groups of patients.
The results revealed that the average number of resected lymph node in the EITHBC group was significantly higher in the recL106 and TbL106 stations (recL106: 1.75 vs. 1.51, p = 0.016, TbL106: 1.53 vs. 1.19, p = 0.016) and significantly lower in the 107 stations (1. 74 vs. 2. 07, p < 0.001) than in the McMIE group. The intraoperative blood loss in the EITHBC group was significantly lower than that in the McMIE group (63.30 vs. 80.45 mL, p < 0.001). The incidence of postoperative pulmonary complications in the EITHBC group was lower than that in the McMIE group (14.15% vs. 27.45%, p = 0.008). The incidence of recurrent laryngeal nerve paralysis in the EITHBC group was significantly higher than that in the McMIE group (26.41% vs. 10.46%, p = 0.003).
Compared with the McMIE procedure, the EITHBC procedure has advantages in terms of removing the upper mediastinal lymph nodes and reducing postoperative pulmonary complications.
摘要：
背景：McKeown微创食管切除术（McMIE）具有各种局限性，包括手术禁忌症和术后肺部并发症的高发生率。在这项研究中，通过使用食管内陷和经双侧宫颈入路（ETHBC）描述了一种新颖的纵隔镜食管切除术。
方法：根据操作方式，总共259名患者被分为两组，其中106例接受了EITHBC，153例接受了McMIE。解剖的淋巴结数量，术中结果,比较两组患者的术后结局。
结果：结果显示，在recL106和TbL106站中，EITHBC组的平均切除淋巴结数明显更高（recL106：1.75vs.1.51，p=0.016，TbL106：1.53vs.1.19，p=0.016），在107个站点中（1。74vs.2.07，p<0.001）比McMIE组。EITHBC组术中出血量明显低于McMIE组(63.30vs.80.45mL,p<0.001)。ETHBC组术后肺部并发症发生率低于McMIE组(14.15%vs.27.45%,p=0.008)。EITHBC组喉返神经麻痹的发生率明显高于McMIE组（26.41%vs.10.46%，p=0.003)。
结论：与McMIE程序相比，在去除上纵隔淋巴结和减少术后肺部并发症方面,ETHBC手术具有优势.
方法：根据操作方式，总共259名患者被分为两组，其中106例接受了EITHBC，153例接受了McMIE。解剖的淋巴结数量，术中结果,比较两组患者的术后结局。
结果：结果显示，在recL106和TbL106站中，EITHBC组的平均切除淋巴结数明显更高（recL106：1.75vs.1.51，p=0.016，TbL106：1.53vs.1.19，p=0.016），在107个站点中（1。74vs.2.07，p<0.001）比McMIE组。EITHBC组术中出血量明显低于McMIE组(63.30vs.80.45mL,p<0.001)。ETHBC组术后肺部并发症发生率低于McMIE组(14.15%vs.27.45%,p=0.008)。EITHBC组喉返神经麻痹的发生率明显高于McMIE组（26.41%vs.10.46%，p=0.003)。
结论：与McMIE程序相比，在去除上纵隔淋巴结和减少术后肺部并发症方面,ETHBC手术具有优势.
