Short-term outcomes of minimally invasive Sweet esophagectomy for Siewert type Ⅱ esophagogastric junction adenocarcinoma
10.3760/cma.j.issn.0529-5815.2016.06.014
- VernacularTitle:胸腹腔镜联合微创治疗Siewert Ⅱ型食管胃交界腺癌的近期结果
- Author:
Changqing LIU
1
;
Mingran XIE
;
Mingfa GUO
;
Xiaohui SUN
;
Hanran WU
;
Xiangxiang SUN
;
Meiqing XU
Author Information
1. 安徽医科大学附属省立医院胸外科
- Keywords:
Esophageal neoplasms;
Thoracoscopy;
Laparoscopy
- From:
Chinese Journal of Surgery
2016;54(6):461-465
- CountryChina
- Language:Chinese
-
Abstract:
Objective To describe the technique for minimally invasive Sweet esophagectomy and to evaluate the feasibility,safety and the short-term clinical outcomes of this approach in the treatment of Siewert type Ⅱ esophagogastric junction adenocarcinoma.Methods The clinical data of 122 patients with Siewert type Ⅱ csophagogastric junction adenocarcinoma who received Sweet esophagectomy between October 2013 and June 2015 in Department of Thoracic Surgery,Auhui Provincial Hospital Affiliated with Anhui Medical University was analyzed retrospectively.The study group consisted of 87 men and 35 women,and the ages ranged from 48 to 78 years (median:67 years).Of those 122 patients,47 underwent minimally invasive approach and 75 underwent open left transthoracic sweet esophagectomy.This study included16 stage Ⅰa patients,35 stage Ⅰb patients,32 stage Ⅱ a patients,28 stage Ⅲ b patients,and 11 stage]Ⅲa patients.The clinicopathologic factors,operational factors and postoperative complications of the two groups were compared by t test and X2 test.Results The two groups were similar in terms of gender,age,American Society of Anesthesiologists grade,preoperative staging and incidence of comorbidities (P ＞0.05).The minimally invasive approach was associated with significant increase in the number of total lymph nodes dissected or the stations of the total lymph nodes dissected (1 8.1 ± 2.7 vs.15.0 ± 2.5,t =6.612,P =0.001;8.9 ± 1.1 vs.6.7 ± 1.2,t =9.960,P =0.003),significant decrease in surgical blood loss ((88 ±32) ml vs.(120 ±34) ml,t =5.052,P =0.001),chest tube duration ((8 ±4) d vs.(10 ±4) d,t=3.110,P=0.002) and postoperative stay ((9 ±5) d vs.(12 ±4) d,t=3.167,P=0.002)relative to the open approach.The postoperative in-hospital mortality and total morbidity did not differ between the two groups (P ＞ 0.05).The minimally invasive approach was associated with significantly fewer respiratory complications than the open approach (8.5％ vs.22.7％,X2 =4.063,P =0.044).Conclusion Minimally invasive technique for Siewert type Ⅱ esophagogastric junction adenocarcinoma can be safely and effectively performed for intrathoracic anastomosis with favorable early outcomes.
