Nursing outcome comparison of laparoscopy-assisted, pneumomediastinoscopy-assisted esophagectomy vs conventional thoracoscopic-assisted, three-incision esophagectomy in early esophageal cancer

BACKGROUND Surgical resection is an important component of curative therapy for early and locally advanced esophageal cancers.Despite the advantages of conventional open esophagectomy, it results in considerable surgical trauma, cardiopulmonary burden, and a high rate of postoperative respiratory and cardiac complications.To address these limitations, mediastinoscopy-assisted and pneumomediastinum-based esophagectomy techniques have been introduced and refined.Nursing teams play a central role in coordinating mobilization schedules, respiratory exercises, drain care, and nutritional advancement as well as in monitoring early signs of clinical deterioration.As such, detailed reports addressing relevant nursing outcomes of new mediastinoscopy-assisted strategies are of particular interest.AIM To compare perioperative and early recovery outcomes between laparoscopy-assisted pneumomediastinoscopy-assisted esophagectomy (LAPA-PMAE) and conventional thoracoscopic-assisted, three-incision esophagectomy for early esophageal cancer.METHODS This retrospective cohort study screened 136 consecutive patients with resectable early thoracic esophageal cancer who underwent minimally invasive esophagectomy at the First Affiliated Hospital of Fujian Medical University (Fuzhou, Fujian Province, China).After excluding patients who underwent emergency or non-elective surgery, combined major procedures on other organs, had incomplete perioperative or follow-up data, died during the index operation, or fulfilled other exclusion criteria, 110 patients were divided into 2 groups: Conventional thoracoscopic-assisted, three-incision esophagectomy (control, n = 60); and LAPA-PMAE (observation, n = 50). RESULTS / 34Chronic obstructive or other chronic lung diseases were more prevalent in the observation group, whereas other baseline variables were similar.Operative duration and blood loss were lower in the observation group.Patients in this group achieved earlier ambulation and oral intake, had a shorter drain duration, shorter postoperative hospital stay, and a more favorable recovery speed index.Overall complication rates were comparable, whereas postoperative arrhythmia occurred only in the control group.After adjusting for baseline factors, the LAPA-PMAE approach remained associated with a shorter hospital stay, suggesting that the observed difference in hospital length of stay was not fully accounted for by the measured risk variables.Lymph node yield was comparable between groups, whereas patient-controlled analgesia use and rescue analgesic use were lower in the observation group.CONCLUSION LAPA-PMAE in a single supine position through cervical and upper abdominal access is associated with a lighter perioperative profile, faster early recovery, and shorter hospitalization.