{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:25:50Z","timestamp":1782797150117,"version":"3.54.5"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T00:00:00Z","timestamp":1732233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Esophagectomy with lymphadenectomy is the primary treatment for esophageal squamous cell carcinoma (ESCC). However, intensive dissection of lymph nodes (LNs) along the recurrent laryngeal nerve (RLN) is associated with RLN palsy and pulmonary complications leading to poor survival. Therefore, this study aimed identify the risk factors for LNs metastasis along the RLN in patients with ESCC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The present study included 168 patients with lower thoracic esophageal and esophagogastric junction (EGJ) squamous cell carcinoma who underwent esophagectomy with total mediastinal lymphadenectomy at Kobe University Hospital. Left\/Right cervical paraesophageal (101\u00a0L\/R), left\/right recurrent nerve (106 recL\/R), and left tracheobronchial LNs (106 tbL) were defined as LNs along the RLN. We evaluated the pathological distance between the proximal tumor boundary and the EGJ using images of the fixed specimen (PB\u2010EGJ length).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>LN metastasis along the RLN was observed in 19 (11%) patients. The percentage of patients with a longer PB\u2010EGJ length and cLNs metastasis was higher in the LNs metastasis along the RLN positive\u2010group than in the RLN\u2010negative group (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0075 and <jats:italic>p<\/jats:italic>\u00a0=\u00a00.013, respectively). The incidence of LNs metastasis along the RLN was 0% (95% confidence interval [CI]\u00a0=\u00a00\u20137.7%) when the PB\u2010EGJ length was &lt;4\u00a0cm. Univariate analysis showed that patients with cLNs metastasis negative had a low risk for LNs metastasis along the RLN (odds ratio\u00a0=\u00a00.26 and 95% CI\u00a0=\u00a00.083\u20130.82).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with a PB\u2010EGJ length &lt;4\u00a0cm and negative for cLNs metastasis may be candidates for the omission of lymphadenectomy along the RLN.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12427","type":"journal-article","created":{"date-parts":[[2024,11,23]],"date-time":"2024-11-23T07:24:09Z","timestamp":1732346649000},"page":"494-501","source":"Crossref","is-referenced-by-count":4,"title":["Omission of lymph node dissection along the recurrent laryngeal nerve for lower thoracic esophageal squamous cell carcinoma with short esophageal invasion"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8082-7134","authenticated-orcid":false,"given":"Yasufumi","family":"Koterazawa","sequence":"first","affiliation":[{"name":"Division of Gastrointestinal Surgery Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4337-5529","authenticated-orcid":false,"given":"Hironobu","family":"Goto","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery Department of Surgery Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Saiga","sequence":"additional","affiliation":[{"name":"Division of Gastrointestinal Surgery Department of Surgery Kobe University Graduate School of Medicine  Kobe 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