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Novel minimally invasive approach to lymph node dissection around the left renal vein in patients with esophagogastric junction cancer

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Abstract

The left renal vein lymph node (LRVLN) may be the extended locoregional node in esophagogastric junction cancer; however, only open-surgical methods of dissection have been reported. We therefore developed a novel minimally invasive laparoscopic method for LRVLN dissection. Following esophagectomy, the stomach was mobilized and LRVLN dissection was started by taping the pancreatic body using two silicone drains. The transverse mesocolon was then retracted through the superior duodenal fossa to expose the horizontal duodenum and permit LRVLN dissection. We carried out the procedure successfully in 17 patients with advanced esophagogastric cancer. The median total and laparoscopic operative times were 415 and 161 min, respectively. Postoperative esophagectomy-related complications occurred in six patients. The median estimated blood loss was 120 ml and hospital stay was 15 days. This minimally invasive laparoscopic LRVLN dissection method was safe and effective, and may support faster recovery and earlier postoperative adjuvant therapy in patients with esophagogastric junction cancer.

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Acknowledgements

We appreciate the members of the Division of Esophageal Surgery for critical discussions of our manuscript. We also thank Mr. Hirofumi Fuji for ensuring that the video file conformed to the regulations. We also thank Mr. Edward Charles Yoshiyuki Bickel for description in video.

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Authors and Affiliations

  1. Division of Esophageal Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Hiroyuki Daiko, Junya Oguma, Ataru Sato, Yuki Hirano, Daisuke Kurita & Koshiro Ishiyama

  2. Division of Esophageal Surgery, National Cancer Center Hospital East, Chiba, Japan

    Hiroyuki Daiko, Takeo Fujita, Takuji Sato, Kazuma Sato & Hisashi Fujiwara

Authors
  1. Hiroyuki Daiko
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  2. Takeo Fujita
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  3. Junya Oguma
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  4. Takuji Sato
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  5. Ataru Sato
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  6. Kazuma Sato
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  7. Yuki Hirano
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  8. Daisuke Kurita
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  9. Koshiro Ishiyama
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  10. Hisashi Fujiwara
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Corresponding author

Correspondence to Hiroyuki Daiko.

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Daiko, H., Fujita, T., Oguma, J. et al. Novel minimally invasive approach to lymph node dissection around the left renal vein in patients with esophagogastric junction cancer. Esophagus 18, 420–423 (2021). https://doi.org/10.1007/s10388-020-00786-x

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  • DOI: https://doi.org/10.1007/s10388-020-00786-x

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