切换至 "中华医学电子期刊资源库"

中华胸部外科电子杂志 ›› 2024, Vol. 11 ›› Issue (03) : 201 -207. doi: 10.3877/cma.j.issn.2095-8773.2024.03.09

综述

食管鳞癌喉返神经旁淋巴结清扫及功能保护相关研究进展
王睿臻1, 段晓峰1, 姜宏景1,()   
  1. 1. 300181 天津,天津医科大学肿瘤医院食管肿瘤微创外科,国家恶性肿瘤临床医学研究中心,天津市恶性肿瘤临床医学研究中心
  • 收稿日期:2024-04-11 修回日期:2024-05-19 接受日期:2024-06-27 出版日期:2024-08-28
  • 通信作者: 姜宏景
  • 基金资助:
    天津市医学重点学科(专科)建设项目(TJYXZDXK-010A)

Research progress on recurrent laryngeal para-lymph node dissection and functional protection of esophageal squamous cell carcinoma

Ruizhen Wang1, Xiaofeng Duan1, Hongjing Jiang1,()   

  1. 1. Department of Minimally Invasive Esophageal Surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clincial Research Center for Cancer, Tianjin 300181, China
  • Received:2024-04-11 Revised:2024-05-19 Accepted:2024-06-27 Published:2024-08-28
  • Corresponding author: Hongjing Jiang
引用本文:

王睿臻, 段晓峰, 姜宏景. 食管鳞癌喉返神经旁淋巴结清扫及功能保护相关研究进展[J]. 中华胸部外科电子杂志, 2024, 11(03): 201-207.

Ruizhen Wang, Xiaofeng Duan, Hongjing Jiang. Research progress on recurrent laryngeal para-lymph node dissection and functional protection of esophageal squamous cell carcinoma[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2024, 11(03): 201-207.

食管癌是常见的恶性肿瘤之一,发病率和死亡率均较高。中国最常见的组织病理学类型是食管鳞状细胞癌(ESCC)。ESCC的淋巴结(LN)复发和转移是影响患者预后和长期生存的重要因素。ESCC患者双侧喉返神经(recurrent laryngeal nerves,RLNs)旁LN转移率高,因此RLN旁LN清扫是食管切除术中最重要的步骤。然而,RLN旁LN清扫可能会损伤RLNs,产生相应的并发症,如声嘶等。如何有效地清扫LN的同时保护RLNs的功能是食管切除术的主要挑战之一。近年来,随着机器人辅助微创外科的发展,机器人辅助微创食管切除术得到了广泛应用。本综述讨论RLNs旁LN清扫的必要性及相关外科进展,RLNs损伤的相关危险因素及其功能保护。

Esophageal cancer is one of the most common malignancies, with high morbidity and mortality. In China, the most common histopathological type of esophageal cancer is esophageal squamous cell carcinoma (ESCC) . Lymph node recurrence and metastasis of ESCC are important factors affecting the prognosis and seriously affecting the long-term survival of patients. ESCC patients have a high rate of lymph node metastasis adjacent to the bilateral recurrent laryngeal nerves (RLNs) . Therefore, para-RLN lymph node dissection is the most important step in esophagectomy. However, the procedure may damage the RLNs and produce corresponding complications such as hoarseness. How to effectively perform lymph node dissection while preserving the function of RLNs is the main challenge in esophagectomy. In recent years, with the development of robot-assisted minimally invasive surgery, robot-assisted minimally invasive esophagectomy has been widely used. Therefore, the purpose of this review is to discuss the necessity of para-RLN lymph node dissection, relevant surgical advancements, risk factors associated with RLNs injury, and methods for esophageal cancer.

1
Rouvelas IZeng WLindblad M,et al.Survival after surgery for oesophageal cancer: a population-based study[J].Lancet Oncol20056(11):864-870.
2
Sung HFerlay JSiegel RL,et al.Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries[J].CA Cancer J Clin202171(3):209-249.
3
Hosoda KNiihara MHarada H,et al.Robot-assisted minimally invasive esophagectomy for esophageal cancer: Meticulous surgery minimizing postoperative complications[J].Ann Gastroenterol Surg20204(6):608-617.
4
Boerner TCarr RAHsu M,et al.Incidence and management of esophageal cancer recurrence to regional lymph nodes after curative esophagectomy[J].Int J Cancer2023152(10):2109-2122.
5
Matsuda STakeuchi MKawakubo H,et al.Lymph node metastatic patterns and the development of multidisciplinary treatment for esophageal cancer[J].Dis Esophagus2023
6
Wang YZhu LXia W,et al.Anatomy of lymphatic drainage of the esophagus and lymph node metastasis of thoracic esophageal cancer[J].Cancer Manag Res201810:6295-6303.
7
Wang ZMao YGao S,et al.Lymph node dissection and recurrent laryngeal nerve protection in minimally invasive esophagectomy[J].Ann N Y Acad Sci20201481(1):20-29.
8
赵越,毛友生.胸段食管鳞癌淋巴结转移规律及淋巴结清扫方式的选择[J].中华胃肠外科杂志201821(9):987-994.
9
Hong THKim HKLee G,et al.Role of Recurrent Laryngeal Nerve Lymph Node Dissection in Surgery of Early-Stage Esophageal Squamous Cell Carcinoma[J].Ann Surg Oncol202229(1):627-639.
10
袁立功,毛友生.食管癌喉返神经旁淋巴结清扫的价值及相关并发症[J].中华肿瘤杂志202244(7):712-716.
11
Li HYang SZhang Y,et al.Thoracic recurrent laryngeal lymph node metastases predict cervical node metastases and benefit from three-field dissection in selected patients with thoracic esophageal squamous cell carcinoma[J].J Surg Oncol2012105(6):548-552.
12
Takeuchi HKitagawa Y.Sentinel node navigation surgery in esophageal cancer[J].Ann Gastroenterol Surg20193(1):7-13.
13
Zhang SLiu QLi B,et al.Clinical significance and outcomes of bilateral and unilateral recurrent laryngeal nerve lymph node dissection in esophageal squamous cell carcinoma: A large-scale retrospective cohort study[J].Cancer Med202211(7):1617-1629.
14
Qu RTu DPing W,et al.The Impact of the Recurrent Laryngeal Nerve Injury on Prognosis After McKeown Esophagectomy for ESCC[J].Cancer Manag Res202113:1861-1868.
15
Demarest CTChang AC.The Landmark Series: Multimodal Therapy for Esophageal Cancer[J].Ann Surg Oncol202128(6):3375-3382.
16
Shanmugasundaram RHopkins RNeeman T,et al.Minimally invasive McKeown's vs open oesophagectomy for cancer: A meta-analysis[J].Eur J Surg Oncol201945(6):941-949.
17
Li ZGai CZhang Y,et al.Comparisons of minimally invasive esophagectomy and open esophagectomy in lymph node metastasis/dissection for thoracic esophageal cancer[J].Chin Med J (Engl)2022135(20):2446-2452.
18
Visser EMarkar SRRuurda JP,et al.Prognostic Value of Lymph Node Yield on Overall Survival in Esophageal Cancer Patients: A Systematic Review and Meta-analysis[J].Ann Surg2019269(2):261-268.
19
Mann CBerlth FHadzijusufovic E,et al.Minimally invasive esophagectomy: clinical evidence and surgical techniques[J].Langenbecks Arch Surg2020405(8):1061-1067.
20
Watanabe MKuriyama KTerayama M,et al.Robotic-Assisted Esophagectomy: Current Situation and Future Perspectives[J].Ann Thorac Cardiovasc Surg202329(4):168-176.
21
Gong LJiang HYue J,et al.Comparison of the short-term outcomes of robot-assisted minimally invasive, video-assisted minimally invasive, and open esophagectomy[J].J Thorac Dis202012(3):916-924.
22
Deng HYLuo JLi SX,et al.Does robot-assisted minimally invasive esophagectomy really have the advantage of lymphadenectomy over video-assisted minimally invasive esophagectomy in treating esophageal squamous cell carcinoma? A propensity score-matched analysis based on short-term outcomes[J].Dis Esophagus201932::doy110.
23
Chao YKHsieh MJLiu YH,et al.Lymph Node Evaluation in Robot-Assisted Versus Video-Assisted Thoracoscopic Esophagectomy for Esophageal Squamous Cell Carcinoma: A Propensity-Matched Analysis[J].World J Surg201842(2):590-598.
24
Fujita TSato KOzaki A,et al.Propensity-Matched Analysis of the Short-Term Outcome of Robot-Assisted Minimally Invasive Esophagectomy Versus Conventional Thoracoscopic Esophagectomy in Thoracic Esophageal Cancer[J].World J Surg202246(8):1926-1933.
25
Hosoda KNiihara MUshiku H,et al.Prevention of intra-thoracic recurrent laryngeal nerve injury with robot-assisted esophagectomy[J].Langenbecks Arch Surg2020405(4):533-540.
26
Yang YLi BYi J,et al.Robot-assisted Versus Conventional Minimally Invasive Esophagectomy for Resectable Esophageal Squamous Cell Carcinoma:Early Results of a Multicenter Randomized Controlled Trial:the RAMIE Trial[J].Ann Surg2022275(4):646-653.
27
Kanamori JWatanabe MMaruyama S,et al.[J].Surg Today202252(9):1246-1253.
28
Park SYSuh JWKim DJ,et al.Near-Infrared Lymphatic Mapping of the Recurrent Laryngeal Nerve Nodes in T1 Esophageal Cancer[J].Ann Thorac Surg2018105(6):1613-1620.
29
Jiang HTeng HSun Y,et al.Near-Infrared Fluorescent Image-Guided Lymphatic Mapping in Esophageal Squamous Cell Carcinoma[J].Ann Surg Oncol202027(10):3799-3807.
30
Rice TWIshwaran HFerguson MK,et al.Cancer of the Esophagus and Esophagogastric Junction: An Eighth Edition Staging Primer[J].J Thorac Oncol201712(1):36-42.
31
Japanese Classification of Esophageal Cancer, 11th Edition: part I[J].Esophagus201714(1):1-36.
32
Duan XYue JChen C,et al.Lymph node dissection around left recurrent laryngeal nerve: robot-assisted vs. video-assisted McKeown esophagectomy for esophageal squamous cell carcinoma[J].Surg Endosc202135(11):6108-6116.
33
尚晓滨,段晓峰,岳杰,等.机器人手术系统辅助食管切除术左侧喉返神经旁淋巴结清扫策略和技术要点[J].中华消化外科杂志202120(5):497-503.
34
Duan XYue JShang X,et al.Learning Curve of Robot-Assisted Lymph Node Dissection of the Left Recurrent Laryngeal Nerve: A Retrospective Study of 417 Patients[J].Ann Surg Oncol202330(7):3991-4000.
35
Peng JSKukar MMann GN,et al.Minimally Invasive Esophageal Cancer Surgery[J].Surg Oncol Clin N Am201928(2):177-200.
36
Ozawa SKoyanagi KNinomiya Y,et al.Postoperative complications of minimally invasive esophagectomy for esophageal cancer[J].Ann Gastroenterol Surg20204(2):126-134.
37
Xing HHu MWang Z,et al.Short-term outcomes of Ivor Lewis vs. McKeown esophagectomy: A meta-analysis[J].Front Surg20229:950108.
38
郭旭峰,张晓彬,李斌,等. 食管癌根治术后声带麻痹对于辅助治疗完成率及远期生存的影响[J].中华胸部外科电子杂志20185(2):75-79.
39
Zhang YHan YGan Q,et al.Early Outcomes of Robot-Assisted Versus Thoracoscopic-Assisted Ivor Lewis Esophagectomy for Esophageal Cancer: A Propensity Score-Matched Study[J].Ann Surg Oncol201926(5):1284-1291.
40
Yang YLi BXu X,et al.Short-term and long-term effects of recurrent laryngeal nerve injury after robotic esophagectomy[J].Eur J Surg Oncol202349(10):107009.
41
Zhu ZYLuo RJHe ZF,et al.Learning Curve for Lymph Node Dissection Around the Recurrent Laryngeal Nerve in McKeown Minimally Invasive Esophagectomy[J].Front Oncol202111:654674.
42
Kuo CTChiu CHFang TJ,et al.Prognostic Factors for Recovery from Left Recurrent Laryngeal Nerve Palsy After Minimally Invasive McKeown Esophagectomy:A Retrospective Study[J].Ann Surg Oncol202431(3):1546-1552.
43
Li YGarrett GZealear D.Current Treatment Options for Bilateral Vocal Fold Paralysis:A State-of-the-Art Review[J].Clin Exp Otorhinolaryngol201710(3):203-212.
44
Jeon YJCho JHLee HK,et al.Management of patients with bilateral recurrent laryngeal nerve paralysis following esophagectomy[J].Thorac Cancer202112(12):1851-1856.
45
中华耳鼻咽喉头颈外科杂志编辑委员会咽喉组,中华医学会耳鼻咽喉头颈外科学分会咽喉学组,中华医学会耳鼻咽喉头颈外科学分会嗓音学组.声带麻痹诊断及治疗专家共识[J].中华耳鼻咽喉头颈外科杂志202156(3):198-209.
46
Sato YKosugi SAizawa N,et al.Risk Factors and Clinical Outcomes of Recurrent Laryngeal Nerve Paralysis After Esophagectomy for Thoracic Esophageal Carcinoma[J].World J Surg201640(1):129-136.
47
Shimizu HShiozaki AFujiwara H,et al.Short- and Long-term Progress of Recurrent Laryngeal Nerve Paralysis After Subtotal Esophagectomy[J].Anticancer Res201737(4):2019-2023.
48
周阳,方亮,王路遥,等.内镜下应用新型组织工程材料修复喉返神经损伤引起的声带麻痹的效果[J].中国内镜杂志202329(10):21-25.
49
Kay JKParsel SMMarsh JJ,et al.Risk of SARS-CoV-2 Transmission During Flexible Laryngoscopy: A Systematic Review[J].JAMA Otolaryngol Head Neck Surg2020146(9):851-856.
50
Zhu YXu STeng X,et al.Refining postoperative monitoring of recurrent laryngeal nerve injury in esophagectomy patients through transcutaneous laryngeal ultrasonography[J].Esophagus202421(2):141-149.
51
中国医疗保健国际交流促进会甲状腺疾病学分会,中华预防医学会甲状腺疾病防治专业委员会,中华医学会耳鼻咽喉-头颈外科学分会头颈学组.局部晚期分化型甲状腺癌累及喉神经处理策略专家共识[J].中华医学杂志2024104(2):125-131.
52
Takeda SIida MKanekiyo S,et al.Efficacy of intraoperative recurrent laryngeal neuromonitoring during surgery for esophageal cancer[J].Ann Gastroenterol Surg20215(1):83-92.
53
Zhao LHe JQin Y,et al.Application of intraoperative nerve monitoring for recurrent laryngeal nerves in minimally invasive McKeown esophagectomy[J].Dis Esophagus202235(7):doab080.
54
刘强,吴云龙,秦鸿翔,等.食管癌术中神经监测对喉返神经的保护价值探讨[J].中文科技期刊数据库(全文版)医药卫生2023(3):65-68.
55
Tsunoda SShinohara HKanaya S,et al.Mesenteric excision of upper esophagus: a concept for rational anatomical lymphadenectomy of the recurrent laryngeal nodes in thoracoscopic esophagectomy[J].Surg Endosc202034(1):133-141.
56
Chen BYang TWang W,et al.Application of Intraoperative Neuromonitoring (IONM) of the Recurrent Laryngeal Nerve during Esophagectomy: A Systematic Review and Meta-Analysis[J].J Clin Med202312(2):565.
57
Wong IYHZhang RQTsang RKY,et al.Improving Outcome of Superior Mediastinal Lymph Node Dissection During Esophagectomy: A Novel Approach Combining Continuous and Intermittent Recurrent Laryngeal Nerve Monitoring[J].Ann Surg2021274(5):736-742.
[1] 任俊筱, 浦路桥, 王志豪, 施洪鑫, 刘爱峰, 齐保闯, 徐永清, 李川. 机器人辅助全膝关节置换术的临床疗效对照研究[J]. 中华关节外科杂志(电子版), 2024, 18(04): 469-476.
[2] 丁莹莹, 宋恺, 金姬延, 田华. 机器人辅助膝髋关节置换术后精细化临床护理[J]. 中华关节外科杂志(电子版), 2024, 18(04): 553-557.
[3] 高一飞, 刘根祥, 孙长华, 周广军. 喉返神经监测在无充气腋窝入路腔镜单侧甲状腺切除+中央区淋巴结清扫术中的应用效果[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 483-486.
[4] 张金华, 赵锁. 早期ICC腹腔镜肝切除术不同淋巴结清扫范围的近远期效果对比研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 578-581.
[5] 田文. 甲状腺癌功能性根治颈淋巴结清扫术[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 482-482.
[6] 彭程程, 张雅琪. 无充气经腋窝入路腔镜手术治疗甲状腺微小乳头状癌的临床疗效及对比研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(04): 442-444.
[7] 赵淑樱, 张聃. 腹腔镜胃癌外科治疗进展与发展趋势[J]. 中华普外科手术学杂志(电子版), 2024, 18(04): 459-462.
[8] 嵇晋, 吴胜文, 姜明瑞, 汪刘华, 王伟, 任俊, 王道荣, 马从超. 三种方式关闭盆底联合改良造口在直肠癌腹会阴联合切除术的对比研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(04): 406-410.
[9] 台苏鹏, 梁朝朝, 郝宗耀, 邰胜, 陶军跃, 周骏. 机器人辅助腹腔镜治疗肾错构瘤合并下腔静脉瘤栓两例报道并文献复习[J]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 473-478.
[10] 王岩, 钱宏阳, 朱寅杰, 董柏君, 潘家骅, 薛蔚. 机器人辅助单孔腹膜外根治性前列腺切除治疗高危前列腺癌的瘤控效果初探[J]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 435-440.
[11] 苏博兴, 肖博, 李建兴. 2024年美国泌尿外科学会年会结石领域手术治疗相关热点研究及解读[J]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 303-308.
[12] 李澄清, 郭文毅, 王磊. 腹腔镜保留脾脏胰体尾切除术:微创胰腺外科的合理决策[J]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 620-624.
[13] 郭诗翔, 谭明达, 王槐志. 胰头癌淋巴结清扫再思考[J]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 625-628.
[14] 周倜, 吴嘉, 韩方, 徐林伟, 张宇华. 新辅助治疗时代胰腺癌淋巴结清扫研究进展[J]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 634-639.
[15] 辛万鹏, 黄俊甫, 肖卫东. 机器人保留器官功能的胰腺切除术临床应用[J]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 461-465.
阅读次数
全文


摘要