Chen WS, Zhu LH, Li WJ, Tu PJ, Huang JY, You PL, Pan XJ. Novel technique for lymphadenectomy along left recurrent laryngeal nerve during thoracoscopic esophagectomy. World J Gastroenterol 2020; 26(12): 1340-1351 [PMID: 32256021 DOI: 10.3748/wjg.v26.i12.1340]
Corresponding Author of This Article
Wen-Shu Chen, MD, Associate Professor, Chief Doctor, Surgeon, Surgical Oncologist, Department of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, No. 134 East Street, Fuzhou 350001, Fujian Province, China. doctorcws@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Wen-Shu Chen, Li-Huan Zhu, Wu-Jin Li, Peng-Jie Tu, Jian-Yuan Huang, Pei-Lin You, Xiao-Jie Pan, Department of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou 350001, Fujian Province, China
Author contributions: Chen WS and Pan XJ conception and design of the study; Chen WS, Zhu LH, Li WJ and Pan XJ performed the experiments; Huang JY, Tu PJ and You PL analyzed data; Wen-Shu Chen WS and Zhu LH wrote the paper.
Institutional review board statement: The study was reviewed and approved by the institutional review board and the Ethics Committee of Fujian Provincial Hospital (#K2019-06-028).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Wen-Shu Chen, MD, Associate Professor, Chief Doctor, Surgeon, Surgical Oncologist, Department of Thoracic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, No. 134 East Street, Fuzhou 350001, Fujian Province, China. doctorcws@163.com
Received: November 9, 2019 Peer-review started: November 9, 2010 First decision: December 23, 2019 Revised: February 27, 2020 Accepted: March 9, 2020 Article in press: March 9, 2020 Published online: March 28, 2020 Processing time: 139 Days and 21.2 Hours
Core Tip
Core tip: Lymph nodes (LNs) along recurrent laryngeal nerves (RLNs) are highly involved in esophageal carcinoma. Due to limited working space in the superior mediastinum, lymphadenectomy along RLNs is very difficult, especially the left RLN. Our study provides a novel method for lymphadenectomy along the left RLN. The fundamental concept of this novel method was to exfoliate a bilateral pedicled nerve flap, which is a two-dimensional membrane that includes the left RLN, surrounding LNs, and tracheoesophageal vessels. Then, the hollow-out method was performed to transform it to a three-dimensional structure, in which the left RLN and tracheoesophageal vessels could be easily distinguished and preserved during lymphadenectomy. Compared with the conventional method, this novel method not only increased the number of dissected LNs, but also shortened the operative time and reduced the rate of postoperative hoarseness.
