Japan Digestive Disease Week 2025
Invited Lecture (JSGS)
November 01, 11:30–12:00, Room 1 (Kobe International Exhibition Hall No.2 Building Hall (North))
Invited Lecture-20
Results of 3D thoraco-laparoscopic esophagectomy for esophageal squamous cell carcinoma at Vietnam National Cancer Hospital
- Vietnam National Cancer Hospital
Background: Thoraco-laparoscopic esophagectomy using 3D visualization is increasingly applied in the treatment of esophageal squamous cell carcinoma (ESCC). However, data from Southeast Asia, particularly Vietnam, remains limited. This study aimed to evaluate the clinical characteristics, surgical outcomes, and prognostic factors of patients undergoing 3D thoraco-laparoscopic esophagectomy for mid-to-lower ESCC at the Vietnam National Cancer Hospital.
Patients and methods: A total of 75 patients with histologically confirmed mid-to-lower ESCC underwent 3D thoraco-laparoscopic esophagectomy between 2022 and 2024. Preoperative clinical staging was determined by endoscopy, endoscopic ultrasound, CT scan, and multidisciplinary evaluation. Surgical details, postoperative complications, and histopathological results were collected. Disease-free survival (DFS) was assessed using Kaplan-Meier analysis.
Results: Mean patient age was 57.0+-7.1 years. Upfront surgery was performed in 65% of cases, while 35% received neoadjuvant chemoradiotherapy. The mean operative time was 325.6 +- 64.8 minutes, with mean blood loss of 170.4+-79.1 mL. Respiratory complications occurred in 14.6%, and recurrent laryngeal nerve injury in 8%. No 90-day mortality was recorded. A mean of 38.2+-15.3 lymph nodes were dissected per patient. Pathological lymph node metastasis was present in 41.3%, including 34.6% of pT1b cases and 45.5% of patients with complete tumor regression post-neoadjuvant therapy. Abdominal nodes were most commonly involved. Lymph node metastasis correlated significantly with tumor stage, poor differentiation, lymphovascular/perineural invasion, and tumor length >2 cm (p < 0.05). DFS at 6 and 12 months was 95.8% and 86.5%, respectively. Patients with lymph node metastasis had significantly lower DFS (70.4% vs. 94.8% at 22 months, p = 0.04). DFS was also associated with pathological stage and number of metastatic nodes.
Conclusion: 3D thoraco-laparoscopic esophagectomy is a safe and effective approach for mid-to-lower ESCC
Patients and methods: A total of 75 patients with histologically confirmed mid-to-lower ESCC underwent 3D thoraco-laparoscopic esophagectomy between 2022 and 2024. Preoperative clinical staging was determined by endoscopy, endoscopic ultrasound, CT scan, and multidisciplinary evaluation. Surgical details, postoperative complications, and histopathological results were collected. Disease-free survival (DFS) was assessed using Kaplan-Meier analysis.
Results: Mean patient age was 57.0+-7.1 years. Upfront surgery was performed in 65% of cases, while 35% received neoadjuvant chemoradiotherapy. The mean operative time was 325.6 +- 64.8 minutes, with mean blood loss of 170.4+-79.1 mL. Respiratory complications occurred in 14.6%, and recurrent laryngeal nerve injury in 8%. No 90-day mortality was recorded. A mean of 38.2+-15.3 lymph nodes were dissected per patient. Pathological lymph node metastasis was present in 41.3%, including 34.6% of pT1b cases and 45.5% of patients with complete tumor regression post-neoadjuvant therapy. Abdominal nodes were most commonly involved. Lymph node metastasis correlated significantly with tumor stage, poor differentiation, lymphovascular/perineural invasion, and tumor length >2 cm (p < 0.05). DFS at 6 and 12 months was 95.8% and 86.5%, respectively. Patients with lymph node metastasis had significantly lower DFS (70.4% vs. 94.8% at 22 months, p = 0.04). DFS was also associated with pathological stage and number of metastatic nodes.
Conclusion: 3D thoraco-laparoscopic esophagectomy is a safe and effective approach for mid-to-lower ESCC