Application of esophageal wire traction in lymph node dissection during three-hole thoracoscopic McKeown esophagectomy

Introduction: The quality of left recurrent laryngeal nerve lymph node dissection is critical in esophageal cancer. We investigated whether esophageal wire traction in three-hole thoracoscopic esophagectomy can improve the same. Material and methods: We retrospectively analyzed the data of 98 patients who underwent thoracoscopic esophagectomy in our center from January 2018 to July 2018: 36 patients with esophageal wire traction and 62 patients without traction (control group). The clearance time for left recurrent laryngeal nerve lymph nodes, thoracic bleeding volume, number of left recurrent laryngeal nerve lymph nodes, and complications were recorded. Results: The observation group had a shorter clearance time for the left recurrent laryngeal nerve lymph nodes (15.8 +/- 6.9 min vs. 20.00 +/- 6.2 min), less thoracic bleeding (55.8 +/- 30.2 mL vs. 70.7 +/- 30.3 mL), and higher number of dissected left recurrent laryngeal lymph nodes (3.3 +/- 1.4 vs. 2.5 +/- 1.1) than the control group. There was no significant difference in the incidence of anastomotic leakage, pulmonary infection, arrhythmia, chylothorax, and nerve injury. Conclusions: Esophageal wire traction shortens the clearance time for the left recurrent laryngeal nerve lymph nodes, reduces thoracic bleeding, and improves the quality of left recurrent laryngeal nerve lymph node dissection in three-hole thoracoscopic esophagectomy.