PP308 - IMPACT OF TRANSMEDIASTINAL ESOPHAGECTOMY ON POSTOPERATIVE NUTRITIONAL AND BODY COMPOSITION PARAMETERS COMPARED WITH VIDEO-ASSISTED THORACOSCOPIC ESOPHAGECTOMY

PP308

IMPACT OF TRANSMEDIASTINAL ESOPHAGECTOMY ON POSTOPERATIVE NUTRITIONAL AND BODY COMPOSITION PARAMETERS COMPARED WITH VIDEO-ASSISTED THORACOSCOPIC ESOPHAGECTOMY

T. Narita^1,*, K. Fuktsu², S. Murakoshi³, M. Noguchi², H. Takayama², S. Oya¹, Y. Miwa¹, K. Yagi¹, Y. Baba¹

¹Gastrointestinal Surgery, ²Surgical Center, The University of Tokyo, Tokyo, ³ Faculty of Health & Social Work, The Kanagawa University of Human Services, Kanagawa, Japan

Rationale: Although transmediastinal esophagectomy (TME) was developed to reduce surgical stress and we have used this approach since 2011, its nutritional advantages over video-assisted thoracoscopic esophagectomy (VATS) remain unclear.  We retrospectively investigated differences in postoperative nutritional and body composition parameters between TME and VATS.

Methods: We reviewed 38 patients who underwent subtotal esophagectomy at the University of Tokyo Hospital in 2025 (TME: n=25; VATS: n=13).  Body weight, body mass index (BMI), and hematological findings including serum albumin levels (Alb) and lymphocyte count were evaluated preoperatively and on postoperative days (POD) 1, 7, 14, and 30.  Serum prealbumin levels (pre-Alb), muscle mass, and skeletal muscle index (SMI) were assessed preoperatively and on POD 30.  Muscle mass and SMI were measured using bioelectrical impedance analysis.  Continuous variables were compared using appropriate statistical tests, and categorical variables using chi-square or Fisher’s exact test.

Results: Although the rate of low SMI (Men: <7.0kg/m², Women: <5.7 kg/m²) was higher in the VATS group in baseline characteristics than one in the TME group, there were no significant differences in postoperative complications or hospital length of stay between two groups.  Most patients in both groups experienced a decrease in body weight, BMI, muscle mass and SMI after surgery (Table).  However, there were no significant differences in the rate of decline between two groups at any time points.  Similarly, Alb, pre-Alb and lymphocyte count did not show significant differences between two groups at any time points.

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Conclusion: This study did not show significant nutritional advantages of TME over VATS in the early postoperative period.

Disclosure of Interest: None declared