400. CONSTRUCTION OF A MODULAR SYSTEM OF ‘INFLATABLE SINGLE-INCISION MEDIASTINOSCOPY ESOPHAGECTOMY’ BASED ON FASCIA ANATOMY

Abstract Background We improved Inflatable Single-Incision Mediastinoscopy esophagectomy to implement the simultaneous laparoscopic with inflatablesingle-Incision mediastinoscope and lymphadenectomy along bilateral recurrent laryngeal nerves under mediastinoscopy through a single left-neck incision formed concept of modular treatment inflatable mediastinoscopic based on fascial anatomy which we can achieve standardized add programmed esophageal dissociation, greatly shorten learning curve, make it easier popularize promote, help us control operation time complications. Methods According periesophageal fascia summarized six surgical modules, respectively is: To neck incision, dissociate posterior left esophagus, anterior right nerves, dissect Subcarinal lymph nodes. The clinical data patients undergoing single-pore from February 2020 2021 in our hospital were analyzed, compared minimally invasive thoracic esophagectomy, order verify application effect this system. Results In validation study modularization subject, no perioperative death was found 44 R0 resection rate 100% confirmed by postoperative pathology. average 204.9 ± 45.4 minutes, mean intraoperative blood loss 64.6 45.5 mL, number nodes removed 19.5 9.1, length stay 27.0 18.17 days, anastomotic fistula (2.27%), stenosis (13.64%), chylous leakage (0%), pleural effusion (4.55%), pulmonary infection (9.09%), better than group. incidence hoarseness (18.19%) needed be improved. Conclusion This procedure description is proposed for first mediastinoscope, an exploration construction system procedure. enables standardized, rapid has good value.