Thoracolaparoscopic versus open approach for thoracic esophageal squamous cell carcinoma: A case control study
10.7507/1007-4848.201612001
- VernacularTitle:开放手术与腔镜下根治切除术治疗胸段食管鳞癌的病例对照研究
- Author:
ZOU Zhiqiang
1
;
YUAN Lei
1
;
HU Fengbiao
1
;
SUI Gang
1
;
LIU Yu
1
Author Information
1. Department of Thoracic Surgery, Jinan Military General Hospital, Jinan, 250031, P.R.China
- Publication Type:Journal Article
- Keywords:
Thoracic esophageal squamous cell carcinoma;
minimally invasive esophagectomy;
lymph node dissection
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2018;25(1):78-82
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the security and outcomes of thoracolaparoscopic esophagectomy (TLE) versus open approach (OA) for thoracic esophageal squamous cell carcinoma. Methods From June 2014 to June 2015, 125 patients with thoracic esophageal squamous cell carcinoma underwent esophagectomy through McKeown approach, including TLE (a TLE group, 107 patients, 77 males and 30 females) and OA (an OA group, 18 patients, 13 males and 5 females). The data of operation and postoperative complications of the two groups were analyzed retrospectively. Results There was no statistical difference in the duration of operation and ICU stay and resected lymph nodes around laryngeal recurrent nerve between the TLE group and the OA group (333.58±72.84 min vs. 369.17±91.24 min, P=0.067; 2.84±1.44 d vs. 6.44±13.46 d, P=0.272; 4.71±3.87 vs. 3.89±3.97, P=0.408) . There was a statistical difference in blood loss, total resected lymph nodes and resected lymph nodes groups between TLE group and OA group (222.62±139.77 ml vs. 427.78±276.65, P=0.006; 19.62±9.61 vs. 14.61±8.07, P=0.038; 3.70±0.99 vs. 3.11±1.13, P=0.024). The rate of postoperative complications was 32.7% in the TLE group and 38.9% in the OA group (P=0.608). There was a statistical difference (P=0.011) in incidence of pulmonary infection (2.8% in the TLE group and 16.7% in the OA group). Incidences of complications, such as anastomotic leakage, cardiac complications, left-side hydrothorax, right-side pneumothorax, voice hoarse and incision infection, showed no statistical difference between two groups. Conclusion For patients with thoracic esophageal squamous cell carcinoma, TLE possesses advantages of more harvested lymph nodes, less blood loss and less pulmonary infection comparing with open approach, and is complied with the principles of security and oncological radicality of surgery.
