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Published in: Langenbeck's Archives of Surgery 5/2022

21-03-2022 | Esophageal Cancer | Original Article

Double-lumen tube versus bronchial blocker in lymphadenectomy along the left recurrent laryngeal nerve for esophageal cancer: a propensity-matched analysis

Authors: De-Hao Tu, Rirong Qu, Wei Ping, Guang Yang, Xiaoling Ma, Xiangning Fu, Yixin Cai

Published in: Langenbeck's Archives of Surgery | Issue 5/2022

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AbstractQuery

Background

Lymph node (LN) dissection along left recurrent laryngeal nerve (RLN) is challenging in esophagectomy for esophageal cancer, and double-lumen endotracheal tube (DLT) impedes the exposure of this area. The aim of this study was to determine whether bronchial blockers (BB) could be a better choice for this procedure.

Methods

The clinical characteristics of patients who received McKeown esophagectomy with radical lymph node dissection in Wuhan Tongji Hospital between August 2017 and July 2019 were retrospectively analyzed. The 1:1 propensity score match analysis was performed to compare the short-term effectiveness, the numbers of lymph nodes dissected, and the patterns of recurrence and survival between the two groups.

Results

A total of 294 patients (192 and 102 in the DLT and BB group, respectively) were enrolled in the study. After matching, 204 patients (102 pairs) who underwent one-lung ventilation with DLT or BB displayed no significant variance in baseline characteristics. The BB group had higher number of LNs resected along left RLN (1.8 ± 2.3 vs. 2.5 ± 2.5, P = 0.001). For patients with metastatic left RLN LN, the BB group had longer medium survival time (15 vs. 32 months, P = 0.045), and tended to have longer medium recurrence-free survival time (6 vs. 15 months, P = 0.079), and lower rate of upper mediastinal and cervical LN recurrence (30.00% vs. 66.67%, P = 0.198). The postoperative complications were similar in both groups.

Conclusions

Compared with DLT, using BB in esophagectomy may allow more radical lymphadenectomy along left RLN.
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Metadata
Title
Double-lumen tube versus bronchial blocker in lymphadenectomy along the left recurrent laryngeal nerve for esophageal cancer: a propensity-matched analysis
Authors
De-Hao Tu
Rirong Qu
Wei Ping
Guang Yang
Xiaoling Ma
Xiangning Fu
Yixin Cai
Publication date
21-03-2022
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 5/2022
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-022-02475-y

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