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  • Oxford University Press (OUP)  (3)
  • Kosuga, Toshiyuki  (3)
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  • Oxford University Press (OUP)  (3)
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  • 1
    Online Resource
    Online Resource
    152 SURGICAL PROCEDURE AND OUTCOME OF MEDIASTINOSCOPIC RADICAL ESOPHAGECTOMY FOR ESOPHAGOGASTRIC JUNCTION CANCER
    Oxford University Press (OUP) ; 2021
    In:  Diseases of the Esophagus Vol. 34, No. Supplement_1 ( 2021-09-17)
    Details
    In: Diseases of the Esophagus, Oxford University Press (OUP), Vol. 34, No. Supplement_1 ( 2021-09-17)
    Abstract: We started performing mediastinal lymph node dissection by a laparoscopic transhiatal approach (LTHA) in 2009. To date, 371 patients had undergone our method during various esophageal surgical procedures, including esophagogastric junction cancer (EGJC). Furthermore, we started performing single-port mediastinoscopic cervical approach in 2014, and developed a simple technique for transmediastinal radical esophagectomy (TMr) without thoracic approach (258 cases). Forty patients with EGJC were also treated by TMr. Methods Left single-port mediastinoscopic cervical approach was performed with pneumomediastinum. Mainly for advanced SCC, upper mediastinal lymph node dissection including recurrent laryngeal nerve LNs was performed with intraoperative monitoring using NIM system. Next, LTHA was performed for en bloc mediastinal lymph node dissection. The esophageal hiatus was opened, and working space was secured by Long Retractors. The posterior plane of the pericardium was extended. The posterior side of LNs was then separated. Finally, while lifting LNs like a membrane, they were resected from bilateral mediastinal pleura. Reconstruction with narrow gastric conduit was performed through substernal tract. Results Patients with EGJC performed TMr were analyzed (n = 40, SCC/Adeno/Others = 21/17/2). Upper mediastinal lymph node metastasis was found in 6 cases (SCC/Adeno = 3/3), middle mediastinal lymph node metastasis was found in 2 cases (SCC/Adeno = 1/1), and all of them had advanced tumors. Their perioperative outcome were compared with those performed the right thoracotomy (n = 41). The operative time and bleeding were decreased by TMr. The number of resected mediastinal lymph nodes, pR0 rate, and mediastinal recurrence in the two groups were not different. In 95.0% of patients treated by TMr, extubation was performed at 0 POD. Postoperative respiratory complications was decreased by TMr (TMr:7.5%, thoracotomy:17.1%). Conclusion This procedure, TMr, resulted in a good surgical view, safe en-bloc mediastinal lymph node dissection, and the decrease of postoperative respiratory complications in patients with EGJC.
    Type of Medium: Online Resource
    ISSN: 1120-8694 , 1442-2050
    URL: Article
    DOI: 10.1093/dote/doab052.152
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 2
    Online Resource
    Online Resource
    145 ADVANTAGES OF MINIMALLY INVASIVE TRANSMEDIASTINAL ESOPHAGECTOMY IN ELDERLY PATIENTS WITH ESOPHAGEAL CANCER
    Oxford University Press (OUP) ; 2021
    In:  Diseases of the Esophagus Vol. 34, No. Supplement_1 ( 2021-09-17)
    Details
    In: Diseases of the Esophagus, Oxford University Press (OUP), Vol. 34, No. Supplement_1 ( 2021-09-17)
    Abstract: Esophagectomy for esophageal cancer (EC) is one of the most invasive surgical procedures and, especially for elderly patients, postoperative respiratory complication (PRC) is still frequent and life-threatening. We started esophagectomy by a laparoscopic transhiatal approach in 2009, and single-port mediastinoscopic cervical approach in 2014. Nowadays, we have performed total mediastinal lymph node dissection without thoracic approach. The purpose of this study was to evaluate transmediastinal esophagectomy (TME) for the prevention of PRC in elderly patients. Methods 1) Patients with EC performed TME (n = 238) were compared with those performed the right thoracotomy (n = 185). 2) Outcomes of TME for elderly patients (75 years and older, n = 48) was evaluated by comparing with non-elderly patients (n = 190). 3) Elderly patients performed subtotal esophagectomy were divided into 2 groups according to the presence (n = 12) or absence (n = 51) of PRC. The two groups were compared about clinicopathological factors, and risk factors of PRC were analyzed. Results 1) Percentage of elderly patients was higher in TME group (20.2% vs 8.1%). The operative time and bleeding were decreased by TME. The number of resected LNs and pR0 rate were not different between two groups. In TME groups, the occurrence of PRC was significantly reduced (10.1% vs 28.1%). 2) 81.3% of elderly patients were able to extubation on 0POD, and there was no significant difference in PRC between two groups. 3) Univariate analysis showed that surgical approach was significantly different between two groups. Multivariate analysis showed that thoracotomy was the strongest risk factor of PRC for elderly patients. Conclusion This study showed that our surgical procedure was less invasive during operation and resulted in a safe en-bloc mediastinal lymph node dissection. For elderly patients, TME was the effective minimally invasive approach and was able to reduce the occurrence of PRC.
    Type of Medium: Online Resource
    ISSN: 1120-8694 , 1442-2050
    URL: Article
    DOI: 10.1093/dote/doab052.145
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 3
    Online Resource
    Online Resource
    156 THE EXPRESSION AND ROLE OF ANO9 IN HUMAN ESOPHAGEAL SQUAMOUS CELL CARCINOMA
    Oxford University Press (OUP) ; 2021
    In:  Diseases of the Esophagus Vol. 34, No. Supplement_1 ( 2021-09-17)
    Details
    In: Diseases of the Esophagus, Oxford University Press (OUP), Vol. 34, No. Supplement_1 ( 2021-09-17)
    Abstract: The anoctamin (ANO) family consists of transmembrane proteins in 10 isoforms, and ANOs are broadly expressed in epithelial and non-epithelial tissues. Few studies have reported the function and activation mechanism of ANO9 in esophageal squamous cell carcinoma (ESCC), and the clinical significance of its expression remains unclear. The aims of the present study were to investigate the role of ANO9 in the regulation of tumor progression and its clinicopathological significance in ESCC. Methods In human ESCC cell lines KYSE150 and KYSE790, knockdown experiments were performed using ANO9 siRNA, and the effects on cell proliferation, cell cycle, apoptosis, invasion and migration were analyzed. The gene expression profiles of cells were examined using a microarray analysis. Immunohistochemical (IHC) analysis was performed on 57 primary tumor samples obtained from ESCC patients who underwent curative esophagectomy between 1999 and 2009 in Kyoto Prefectural University of Medicine. Results In an in vitro study, the depletion of ANO9 reduced cell proliferation, invasion and migration in KYSE150 and KYSE 790 cells. And, the depletion of ANO9 increased the number of cells in G0/G1 arrest and induced apoptosis in these cells. The results of the microarray analysis indicated that various centrosome-related genes such as CEP120, CNTRL and SPAST, were up- or down-regulated in ANO9-depleted KYSE150 cells. The IHC results showed that high expression of ANO9 was independent prognostic factor in ESCC patients (p = 0.025). Conclusion ANO9 played the important role in the cell cycle and progression of ESCC cells through the expression of centrosome-related genes. In addition, the high expression of ANO9 was a poor prognostic factor in ESCC patients. The results of the present study indicate that ANO9 has potential as a biomarker for cancer growth and as a therapeutic target for ESCC such as inhibitor or RNA interference of ANO9.
    Type of Medium: Online Resource
    ISSN: 1120-8694 , 1442-2050
    URL: Article
    DOI: 10.1093/dote/doab052.156
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2004949-3
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    Online Resource
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