ObjectiveTo investigate the application effect of dual-instrument nurse teamwork in concurrent thoracoscopic and laparoscopic radical resection for esophageal cancer using an inflatable mediastinoscopy. MethodsA retrospective analysis was conducted on surgical data of patients who underwent concurrent thoracoscopic and laparoscopic radical resection for esophageal cancer using an inflatable mediastinoscopy between 2021 and 2024 at five domestic hospitals by the same surgical team. Patients were divided into an observation group (two instrument nurses working simultaneously) and a control group (one instrument nurse working independently) based on the number of instrument nurses involved. After propensity score matching (1:1), the baseline characteristics, perioperative parameters, complication rates, postoperative pulmonary function status, immune stress response indicators, and surgical coordination quality were compared between groups. ResultsA total of 480 patients were enrolled, including 287 males and 193 females with a mean age of (53.90±7.81) years. After propensity score matching, 224 patients were analyzed per group. The operation time in the observation group was significantly shorter than that in the control group [(84.32±19.77) min vs. (95.23±29.54) min, P<0.001]. Compared with the control group, the observation group demonstrated reduced intraoperative blood loss and postoperative drainage volume, earlier first flatus time, oral intake time, and initial ambulation time, lower pain scores at 24 hours postoperatively, and decreased overall complication rates (all P<0.05). However, no significant difference was observed in the number of dissected lymph nodes between groups (P>0.05). Postoperative pulmonary function indicators were significantly higher in the observation group (P<0.05). Immune and stress response markers were markedly lower in the observation group (P<0.05), while the overall surgical coordination quality score was significantly higher (P<0.001). ConclusionDual-instrument nurse teamwork during concurrent thoracoscopic and laparoscopic radical resection for esophageal cancer using an inflatable mediastinoscopy optimizes surgical workflow efficiency and quality, thereby promoting postoperative patient recovery.
Esophageal carcinoma is one of the most common malignant tumor, a serious threat to human health. In the early and middle esophageal carcinoma patients, surgery is the only expected treatment to cure esophageal carcinoma. Traditional surgery of esophageal cancer needs thoracotomy and laparotomy, which has great trauma and high incidence of complications. So surgeons are looking for a minimally invasive surgical methods alternative to traditional esophagectomy. Video-mediastinoscopy is used to free middle and upper esophagus, as a minimally invasive surgical method, it is used in radical resection of esophageal cancer gradually. This article reviews the recent progress and the related research results in the application of mediastinoscopy in the radical resection of esophageal cancer. It is found that mediastinoscopy assisted the radical resection of esophageal cancer is a safe and feasible operation. It provides a feasible treatment option for early and middle stage esophageal cancer patients with pulmonary insufficiency who can not be resected by thoracoscopy.
Objective To compare the differences in postoperative pulmonary function and quality of life between synchronous and combined mediastinoscopy with laparoscopic radical resection of esophageal cancer, providing evidence for selecting the optimal surgical approach. Methods A retrospective analysis was conducted on patients who underwent minimally invasive mediastinoscopic esophagectomy at Huaihe Hospital of Henan University from January 2023 to January 2025. Patients were divided into two groups based on surgical approach: the synchronized laparoscopic inflatable mediastinoscopy (SPIMSLE) group and the inflatable video-assisted mediastinoscopic transhiatal esophagectomy (IVMTE) group. Propensity score matching (1 : 1) was applied to balance baseline characteristics. Perioperative indicators, pulmonary function (FEV1, FVC, FEV1/FVC ratio), postoperative complications, pain levels (NRS score), and quality of life were statistically analyzed. Results A total of 173 patients were enrolled, including 110 males, 63 females with a mean age of (62.5±6.2) years. After matching, each group comprised 80 patients. No significant differences were observed in gender, age, tumor location, or clinical stage (all P>0.05). The SPIMSLE group demonstrated superior outcomes: shorter operative time [(100.32±15.28) vs. (134.53±16.43) min, P<0.001], less intraoperative blood loss [(40.13±12.73) mL vs. (69.45±12.34) mL, P<0.001), and shorter postoperative hospitalization [(10.50±2.00) d vs. (12.50±2.50) d, P<0.001]. At 1-6 months postoperatively, the SPIMSLE group showed faster recovery in pulmonary function (FEV1, FVC, FEV1/FVC ratio, P<0.05), lower complication rates (16.25% vs. 40%, P<0.001), reduced pain (NRS score, P<0.05), and improved quality of life (P<0.05). No significant difference was noted in lymph node dissection (P>0.05). All patients were followed up until June 2025, with no recurrence, metastasis, or mortality among the 160 cases. Conclusion Compared to IVMTE, SPIMSLE offers shorter operative time, reduced blood loss, faster pulmonary recovery, fewer complications, milder pain, and better quality of life, demonstrating significant clinical advantages.
