ArticleSurgical endoscopy2026
Technical key points and short-term outcomes of fascia-guided radical esophagectomy: a single-center retrospective database analysis.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIn recent years, the "concentric structural model" based on embryonic development and histologically confirmed periesophageal fascial layers has provided a new anatomical orientation for radical esophagectomy. However, a comprehensive evaluation of the technical key points and short-term outcomes of fascia-guided esophagectomy remains lacking. This study aims to elucidate the key technical aspects of this procedure and preliminarily assess its short-term safety and feasibility.
methodsWe retrospectively analyzed the clinical data of 88 patients with thoracic esophageal squamous cell carcinoma who underwent minimally invasive esophagectomy guided by fascial anatomy between January and December 2023. Utilizing the "concentric structural model" and histologically validated fascial planes, esophageal mobilization and en bloc lymph node dissection were performed along these anatomical planes in the upper, middle, and lower mediastinum, as well as the abdominal cavity. Postoperative pathological results and complications (graded using the Clavien-Dindo classification) were analyzed.
resultsThe cohort comprised 67 male patients (76.1%), with a mean age of 61.3 years and a mean BMI of 22.0 kg/m
conclusionFascia-guided radical esophagectomy provides a clear anatomical dissection plane, facilitates en bloc lymph node dissection, and demonstrates acceptable short-term safety and feasibility, however, these findings warrant confirmation in larger, prospective, controlled studies with extended follow-up for oncologic outcomes.
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