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662- MINIMALLY INVASIVE ESOPHAGECTOMY AND RADICAL LYMPH NODE DISSECTION WITHOUT RECURRENT LARYNGEAL NERVE PARALYSIS
EAES Academy. Otsuka K. 01/01/19; 256381; 662
Assoc. Prof. Koji Otsuka
Assoc. Prof. Koji Otsuka
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Abstract
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Introduction:Recurrent laryngeal nerve paralysis(RLNP) is considered a major postoperative complication of esophageal surgery. Although it depends on the extent of lymph node dissection performed, the incidence of RLNP after esophagectomy is reported from 8.3% to 40.9% By avoiding direct nerve injury, unreasonable traction force, thermal damage and other factors associated with RLNP, the incidence of RLNP should be minimized. We reviewed dissection techniques to limit the occurrence of RLNP, with specific attention to the anatomical layer around the recurrent laryngeal nerve. This technique is no touch, no traction and results in no injury to the recurrent laryngeal nerve, maintained in its anatomical position.

Methods: From September 2016 to December 2018, minimally invasive esophagectomy was performed in the left lateral decubitus position in 83 patients with esophageal cancer. The No-Touch Dissection technique for lymphadenectomy around the recurrent laryngeal nerve was performed and all patients evaluated for recurrent laryngeal nerve paralysis.

Results: Minimally invasive esophagectomy was completed in all patients without conversion to thoracotomy. Although an extended lymphadenectomy was performed in all patients, there were no grade II or higher complications (Clavien-Dindo classification) and no incidence of recurrent laryngeal nerve paralysis.

Conclusion: This No-Touch Dissection technique may reduce the incidence of recurrent laryngeal nerve paralysisafter minimally invasive esophagectomy with radical lymph node dissection.
Introduction:Recurrent laryngeal nerve paralysis(RLNP) is considered a major postoperative complication of esophageal surgery. Although it depends on the extent of lymph node dissection performed, the incidence of RLNP after esophagectomy is reported from 8.3% to 40.9% By avoiding direct nerve injury, unreasonable traction force, thermal damage and other factors associated with RLNP, the incidence of RLNP should be minimized. We reviewed dissection techniques to limit the occurrence of RLNP, with specific attention to the anatomical layer around the recurrent laryngeal nerve. This technique is no touch, no traction and results in no injury to the recurrent laryngeal nerve, maintained in its anatomical position.

Methods: From September 2016 to December 2018, minimally invasive esophagectomy was performed in the left lateral decubitus position in 83 patients with esophageal cancer. The No-Touch Dissection technique for lymphadenectomy around the recurrent laryngeal nerve was performed and all patients evaluated for recurrent laryngeal nerve paralysis.

Results: Minimally invasive esophagectomy was completed in all patients without conversion to thoracotomy. Although an extended lymphadenectomy was performed in all patients, there were no grade II or higher complications (Clavien-Dindo classification) and no incidence of recurrent laryngeal nerve paralysis.

Conclusion: This No-Touch Dissection technique may reduce the incidence of recurrent laryngeal nerve paralysisafter minimally invasive esophagectomy with radical lymph node dissection.
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