Application of pleural flaps in laparoscopic-thoracoscopic esophagectomy for esophageal cancer

Background: This study aimed to investigate the clinical efficacy of pleural flaps usage in laparoscopic-thoracoscopic esophagectomy for esophageal cancer. Methods: Six hundred and nineteen patients received esophagectomy for esophageal cancer. All these 619 patients received laparoscopic-thoracoscopic esophagectomy. These 304 patients (study group) used pleural flaps and the other 315 patients (control group) had no pleural flaps. The observation indicators were postoperative complications, including cervical subcutaneous emphysema, fistula of cervical anastomosis, and anastomotic leakage into the pleural cavity. Results: In the study group, 5 patients had cervical subcutaneous emphysema after surgery (1.64%) compared to 38 patients in the control group (12.06%), which showed significant difference (P<0.05). Moreover, the study group displayed 1 case of anastomotic leakage into the pleural cavity (0.33%), compared with 8 patients in the control group (2.54%), which showed significant difference (P<0.05). Logistic regression indicated that the application of pleural flaps effectively reduced the incidence of postoperative complications. Conclusions: Covering the upper mediastinum with pleural flaps effectively reduced the incidence of cervical subcutaneous emphysema and anastomotic leakage into the pleural cavity.