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01-09-2016

Preserving the pulmonary vagus nerve branches during thoracoscopic esophagectomy

Authors: Teus J. Weijs, Jelle P. Ruurda, Misha D. P. Luyer, Grard A. P. Nieuwenhuijzen, Sylvia van der Horst, Ronald L. A. W. Bleys, Richard van Hillegersberg

Published in: Surgical Endoscopy | Issue 9/2016

Abstract

Background

Pulmonary vagus branches are transected as part of a transthoracic esophagectomy and lymphadenectomy for cancer. This may contribute to the development of postoperative pulmonary complications. Studies in which sparing of the pulmonary vagus nerve branches during thoracoscopic esophagectomy is investigated are lacking. Therefore, this study aimed to determine the feasibility and pitfalls of sparing pulmonary vagus nerve branches during thoracoscopic esophagectomy.

Methods

In 10 human cadavers, a thoracoscopic esophagectomy was performed while sparing the pulmonary vagus nerve branches. The number of intact nerve branches, their distribution over the lung lobes and the number and location of the remaining lymph nodes in the relevant esophageal lymph node stations (7, 10R and 10L) were recorded during microscopic dissection.

Results

A median of 9 (range 5–16) right pulmonary vagus nerve branches were spared, of which 4 (0–12) coursed to the right middle/inferior lung lobe. On the left side, 10 (3–12) vagus nerve branches were spared, of which 4 (2–10) coursed to the inferior lobe. In 8 cases, lymph nodes were left behind, at stations 10R and 10L while sparing the vagus nerve branches. Lymph nodes at station 7 were always removed.

Conclusions

Sparing of pulmonary vagus nerve branches during thoracoscopic esophagectomy is feasible. Extra care should be given to the dissection of peribronchial lymph nodes, station 10R and 10L.

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Title: Preserving the pulmonary vagus nerve branches during thoracoscopic esophagectomy
Authors: Teus J. Weijs
Jelle P. Ruurda
Misha D. P. Luyer
Grard A. P. Nieuwenhuijzen
Sylvia van der Horst
Ronald L. A. W. Bleys
Richard van Hillegersberg
Publication date: 01-09-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 9/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4683-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Preserving the pulmonary vagus nerve branches during thoracoscopic esophagectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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