• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Rational lymph node dissection around left recurrent laryngeal nerve in esophageal cancer surgery by thoracoscopic procedure

Rational lymph node dissection around left recurrent laryngeal nerve in esophageal cancer surgery by thoracoscopic procedure

Yusuke Taniyama, Tadashi Sakurai, Takahiro Heishi, Chiaki Sato, Hiroshi Okamoto, Kai Takaya, Takeshi Naito, Michiaki Unno, Takashi Kamei. Tohoku University, Department of Surgery

Background: Lymph node (LN) dissection around recurrent laryngeal nerve (RLN) is one of the most important and difficult procedure in esophageal cancer surgery because of high rate of LN metastasis and risk of RLN palsy. Especially around left RLN, the surgical area is far and narrow by thoracic approach which tends to results in insufficient LN dissection. Therefore, we tried to remove this LN by imaging lymphatic chain to dissect sufficient LN.

Surgical Procedure: We perform thoracoscopic esophagectomy by semi-prone position using 6-10mmHg thoracic air pressure. After dissection of right RLN LN, middle and lower esophagus, encircle the esophagus at the level of bifurcation of bronchus and pull toward right side by tape to dissect the dorsal and left side of upper esophagus. Dissect the tissue including left RLN LN from trachea by pulling esophagus up to dorsal side and try to move this tissue toward dorsal side of left RLN so that this RLN LN tissue can recognize as the “lymphatic chain”. To increase the mobility of esophagus, cut the esophagus at the level of aortic arch and pull further up this upper esophagus to dorsal side.  Cut the esophageal branch of RLN and separate this lymphatic chain from RLN. At the end of thoracic procedure, this lymphatic chain is attached to upper esophagus. After the upper esophagus has pulled out from cervical site, lymphatic chain can easily recognize at the esophageal wall.

Result: We performed this lymphatic chain procedure in 88 cases. To evaluate this procedure, 106 cases of conventional method by same prone positioned esophagectomy was used for control.  There was no statistical difference between these two groups in amount of blood loss (lymphatic chain: conventional = 45ml: 55ml, p=0.524), rate of RLN palsy (14.8% : 14.2%, p=1.00). Although the thoracic operation time was extended in some degree (291min : 270min, p=0.005), number of dissected LN was increased (2.9 :  1.9, p=0.004) and recurrence along left RLN has been relatively fewer by this method (4.5% : 7.5%  p=0.552).

Conclusion: LN dissection around left RLN would be easy and sufficient by imaging lymphatic chain. Further improvement is needed to secure this procedure and further evaluation should be done to support this data.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 85471

Program Number: P725

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

43

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals