The effect of azygos vein preservation on mediastinal lymph node harvesting in thoracic esophagolymphadenectomy

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
J BooneR van Hillegersberg

Abstract

The standard surgical procedure for esophageal cancer is transthoracic esophagectomy with en bloc resection of the azygos vein, thoracic duct and mediastinal lymph nodes. To reduce morbidity of esophago-lymphadenectomy, minimally invasive techniques are increasingly being applied. In (robot-assisted) thoracoscopic esophagolymphadenectomy, the azygos vein is generally left in place, as the scopic ligation of the numerous intercostal veins is technically difficult and time-consuming. This could affect the extent of mediastinal lymph node dissection. Therefore, in this study, the effect of azygos vein preservation during thoracic esophagectomy on mediastinal lymph node harvesting was assessed. In 15 human cadavers, a right-sided thoracotomy was performed, followed by esophagectomy with mediastinal lymph node dissection after ligation of the azygos arch (representing the situation in robot-assisted thoracoscopic esophagolymphadenectomy). Subsequently, the remaining azygos vein with surrounding tissue was resected. The number of lymph nodes in both specimens was determined. A mean of 17.3 (95% Poisson CI 15.3-19.6) lymph nodes was dissected en bloc with the esophagus, and 0.67 (95% Poisson CI 0.32-1.23) around the separately resecte...Continue Reading

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Citations

Jul 3, 2008·Langenbeck's Archives of Surgery·Emile RijckenMatthias Bruewer
Oct 11, 2007·Surgical Endoscopy·J BooneR van Hillegersberg
Feb 19, 2008·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·W SchröderA H Hölscher
Aug 5, 2008·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Judith Boone, Richard van Hillegersberg
Dec 15, 2015·Surgical Endoscopy·Teus J WeijsRichard van Hillegersberg
Jun 26, 2013·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·P Hiranyatheb, H Osugi
Mar 3, 2011·Journal of Neurosurgery. Pediatrics·R Shane TubbsJohn C Wellons
Sep 29, 2020·Langenbeck's Archives of Surgery·Naoto FujiwaraShinichi Sakuramoto
May 11, 2021·The Journal of International Medical Research·Huibing LiuYutao Wei
Mar 17, 2012·World Journal of Surgical Oncology·Shi-Ping LuhChi-Yi Chen

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