Exploration and optimization of surgical techniques for laparoscopic transhiatal lower mediastinal lymph node dissection for adenocarcinoma of esophagogastric junction: A prospective IDEAL 2a study with qualitative design  

作　　者：Yinkui Wang Fanling Hong Shuangxi Li Fei Shan Yongning Jia Rulin Miao Zhemin Li Ziyu Li Jiafu Ji 

机构地区：[1]Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Gastrointestinal Cancer Center,Peking University Cancer Hospital&Institute,Beijing 100142,China [2]Endoscopy Center,Zhongshan Hospital,Fudan University(Xiamen Branch),Xiamen 361015,China

出　　处：《Chinese Journal of Cancer Research》2023年第2期163-175,共13页中国癌症研究（英文版）

基　　金：supportedbyBeijing Municipal Administration of Hospitals(No.DFL20181103);Beijing Hospitals Authority Innovation Studio of Young Staff Funding Support(No.202123).

摘　　要：Objective: To explore the change and feasibility of surgical techniques of laparoscopic transhiatal(TH)-lower mediastinal lymph node dissection(LMLND) for adenocarcinoma of the esophagogastric junction(AEG)according to Idea, Development, Exploration, Assessment, and Long-term follow-up(IDEAL) 2a standards.Methods: Patients diagnosed with AEG who underwent laparoscopic TH-LMLND were prospectively included from April 14, 2020, to March 26, 2021. Clinical and pathological information as well as surgical outcomes were quantitatively analyzed. Semistructured interviews with the surgeon after each operation were qualitatively analyzed.Results: Thirty-five patients were included. There were no cases of transition to open surgery, but three cases involved combination with transthoracic surgery. In qualitative analysis, 108 items under three main themes were detected: explosion, dissection, and reconstruction. Revised instruction was subsequently designed according to the change in surgical technique and the cognitive process behind it. Three patients had anastomotic leaks postoperatively, with one classified as Clavien-Dindo Ⅲa.Conclusions: The surgical technique of laparoscopic TH-LMLND is stable and feasible;further IDEAL 2b research is warranted.

关 键 词：Adenocarcinoma of esophagogastric junction laparoscopic surgery transhiatal approach lower mediastinal lymph node dissection IDEAL 2a research 

分 类 号：R735[医药卫生—肿瘤]