Technique of thoracoscopic dissection of mediastinal lymph node for esophageal cancer

The capability and radicality of thoracoscopic esophagectomy for esophageal cancer were studied. The indication was the lesion less than T3, tolerable for single lung ventilation, and no severe pleural adhesion The procedure was completed in 56 patients with thoracic esophageal cancer. With the righ t lung deflated, a 5-cm mini-thoracotomy was positioned at the 5th intercos tal space (ICS) on the middle axillary line. Four ports were used: at 3rd I CS on the middle axillary line, 5th and 7th ICS on the posterior axillary l ine, and eighth ICS on the anterior axillary line. The maneuver of lymph no de dissection was basically the same as open surgery. Results: We had no ho spital death. The number of dissected mediastinal nodes and amount of blood loss were 34+/-14 and 339+/-366 g, respectively. The thoracic procedure la sted significantly longer in the patients who had thoracoscopic surgery (24 1+/-87 min) than open surgery (196+/-35 min). Whereas in the later 39 patie nts it was 198 min. Conclusion: Thoracoscopic esophagectomy and lymph node dissection can be applied as a routine clinical practice.