Short-term efficacy of minimally invasive esophagectomy combined with three-field versus two-field lymphadenectomy for 257 patients
- VernacularTitle:微创食管切除术联合三野或二野淋巴结清扫术治疗食管鳞状细胞癌257例近期疗效的回顾性队列研究
- Author:
Zengfeng SUN
1
;
Junqiang LIU
2
;
Boshi FAN
2
;
Weian SONG
2
;
Caiying YUE
2
;
Shouying DI
2
;
Jiahua ZHAO
2
;
Shaohua ZHOU
2
;
Hai DONG
2
;
Jusi WANG
2
;
Siyu CHEN
2
;
Taiqian GONG
3
Author Information
1. The Second Clinical College of Southern Medical University, Guangzhou, 510080, P. R. China
2. Department of Thoracic Surgery, Sixth Medical Center, Chinese People s Liberation Army General Hospital, Beijing, 100089, P. R. China
3. 1. The Second Clinical College of Southern Medical University, Guangzhou, 510080, P. R. China 2. Department of Thoracic Surgery, Sixth Medical Center, Chinese People s Liberation Army General Hospital, Beijing, 100089, P. R. China
- Publication Type:Journal Article
- Keywords:
Esophageal squamous cell carcinoma;
minimally invasive esophagectomy;
three-field lymphadenectomy;
two-field lymphadenectomy
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2024;31(04):556-561
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the safety of minimally invasive esophagectomy (MIE) with three-field lymphadenectomy (3-FL) for esophageal squamous cell carcinoma (ESCC) by comparing the short-term outcomes between the 3-FL and the two-field lymphadenectomy (2-FL) in MIE. Methods The clinical data of patients with ESCC who underwent minimally invasive McKeown esophagectomy in our hospital from July 2015 to March 2022 were collected retrospectively. Patients were divided into a 3-FL group and a 2-FL group according to lymph node dissection method. And the clinical outcomes and postoperative complications were compared between the two groups. Results A total of 257 patients with ESCC were included in this study. There were 211 males and 46 females with an average age of 62.2±8.1 years. There were 109 patients in the 3-FL group and 148 patients in the 2-FL group. The operation time of the 3-FL group was about 20 minutes longer than that of the 2-FL group (P<0.001). There was no statistical difference between the two groups in the intraoperatve blood loss (P=0.376). More lymph nodes (P<0.001) and also more positive lymph nodes (P=0.003) were obtained in the 3-FL group than in the 2-FL group, and there was a statistical difference in the pathological N stage between the two groups (P<0.001). But there was no statistical difference in the incidence of anastomotic leak (P=0.667), chyle leak (P=0.421), recurrent laryngeal nerve injury (P=0.081), pulmonary complications (P=0.601), pneumonia (P=0.061), cardiac complications (P=0.383), overall complications (P=0.147) or Clavien-Dindo grading (P=0.152) between the two groups. Conclusion MIE 3-FL can improve the efficiency of lymph node dissection and the accuracy of tumor lymph node staging, but it does not increase the postoperative complications, which is worthy of clinical application.
