Japan Digestive Disease Week 2025
International Session (Symposium)3 (JSGS)
November 01, 9:00–12:00, Room 9 (Portopia Hotel Main Building Kairaku 3)
IS-S3-1_S
RESULTS OF 3D THORACO-LAPAROSCOPIC ESOPHAGECTOMY FOR ESOPHAGEAL SQUAMOUS CELL CARCINOMA AT VIETNAM NATIONAL CANCER HOSPITAL
- National Cancer Hospital of Vietnam
Background: Thoraco-laparoscopic esophagectomy using 3D visualization is increasingly used in treating esophageal squamous cell carcinoma (ESCC). However, data from Southeast Asia, especially Vietnam, remains limited. This study aimed to evaluate clinical characteristics, surgical outcomes, and prognostic factors in patients undergoing 3D thoraco-laparoscopic esophagectomy for mid-to-lower ESCC at the Vietnam National Cancer Hospital.
Patients and methods: We analyzed 75 patients with histologically confirmed mid-to-lower ESCC who underwent surgery between 2022 and 2024. Clinical staging was assessed by endoscopy, ultrasound, CT scan, and multidisciplinary evaluation. Surgical details, postoperative complications, and pathology results were collected. Disease-free survival (DFS) was calculated using Kaplan-Meier analysis.
Results: Mean patient age was 57.0 plus-minus 7.1 years. Upfront surgery was performed in 65 percent of cases, and 35 percent received neoadjuvant chemoradiotherapy. Mean operative time was 325.6 plus-minus 64.8 minutes; blood loss was 170.4 plus-minus 79.1 mL. Respiratory complications occurred in 14.6 percent, and recurrent nerve injury in 8 percent. No 90-day mortality was reported. A mean of 38.2 plus-minus 15.3 lymph nodes were dissected. Lymph node metastasis occurred in 41.3 percent, correlated with tumor stage, differentiation, invasion, and tumor length greater than 2 cm. DFS at 6 and 12 months was 95.8 percent and 86.5 percent, respectively. DFS was significantly lower in patients with nodal metastasis.
Conclusion: 3D thoraco-laparoscopic esophagectomy is safe and effective for mid-to-lower ESCC. Early-stage cases may still present with lymph node metastasis, highlighting the importance of extensive lymphadenectomy and careful staging.
Patients and methods: We analyzed 75 patients with histologically confirmed mid-to-lower ESCC who underwent surgery between 2022 and 2024. Clinical staging was assessed by endoscopy, ultrasound, CT scan, and multidisciplinary evaluation. Surgical details, postoperative complications, and pathology results were collected. Disease-free survival (DFS) was calculated using Kaplan-Meier analysis.
Results: Mean patient age was 57.0 plus-minus 7.1 years. Upfront surgery was performed in 65 percent of cases, and 35 percent received neoadjuvant chemoradiotherapy. Mean operative time was 325.6 plus-minus 64.8 minutes; blood loss was 170.4 plus-minus 79.1 mL. Respiratory complications occurred in 14.6 percent, and recurrent nerve injury in 8 percent. No 90-day mortality was reported. A mean of 38.2 plus-minus 15.3 lymph nodes were dissected. Lymph node metastasis occurred in 41.3 percent, correlated with tumor stage, differentiation, invasion, and tumor length greater than 2 cm. DFS at 6 and 12 months was 95.8 percent and 86.5 percent, respectively. DFS was significantly lower in patients with nodal metastasis.
Conclusion: 3D thoraco-laparoscopic esophagectomy is safe and effective for mid-to-lower ESCC. Early-stage cases may still present with lymph node metastasis, highlighting the importance of extensive lymphadenectomy and careful staging.