Clinical analysis of inflatable video-assisted mediastinoscopic transhiatal esophagectomy combined with laparoscopy.
10.3760/cma.j.cn112139-20220612-00265
- VernacularTitle:充气式纵隔镜联合腹腔镜食管癌切除术的临床分析
- Author:
Zhi Ning HUANG
1
;
Chang Qing LIU
2
;
Ming Fa GUO
2
;
Mei Qing XU
2
;
Xiao Hui SUN
2
;
Gao Xiang WANG
2
;
Ming Ran XIE
1
Author Information
1. Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University, Hefei 230000, China.
2. Department of Thoracic Surgery, the First Affiliated Hospital of University of Science and Technology of China, Hefei 230000, China.
- Publication Type:Journal Article
- MeSH:
Male;
Female;
Humans;
Retrospective Studies;
Esophagectomy/methods*;
Treatment Outcome;
Laparoscopy;
Thoracoscopy;
Lymph Node Excision/methods*;
Esophageal Neoplasms/surgery*;
Postoperative Complications
- From:
Chinese Journal of Surgery
2023;61(1):48-53
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To examine the safety and effectiveness of inflatable video-assisted mediastinoscopic transhiatal esophagectomy (IVMTE). Methods: Totally 269 patients admitted to the Anhui Provincial Hospital of Anhui Medical University who underwent IVMTE (IVMTE group, n=47) or thoracoscopy combined with minimally invasive Mckeown esophageal cancer resection (MIME group, n=222) from September 2017 to December 2021 were analyzed retrospectively. There were 31 males and 16 females in IVMTE group, aged (68.6±7.5) years (range: 54 to 87 years). There were 159 males and 63 females in MIME group, aged (66.8±8.8) years (range: 42 to 93 years). A 1∶1 match was performed on both groups by propensity score matching, with 38 cases in each group. The intraoperative conditions and postoperative complication rates of the two groups were compared by t test, Wilcoxon rank, χ2 test, or Fisher exact probability method. Results: Patients in IVMTE group had less intraoperative bleeding ((96.0±39.2) ml vs. (123.8±49.3) ml, t=-2.627, P=0.011), shorter operation time ((239.1±47.3) minutes vs. (264.2±57.2) minutes, t=-2.086, P=0.040), and less drainage 3 days after surgery (85(89) ml vs. 675(573) ml, Z=-7.575, P<0.01) compared with that of MIME group. There were no statistically significant differences between the two groups in terms of drainage tube-belt time, postoperative hospital stay, and lymph node dissection stations and numbers (all P>0.05). The incidence of Clavien-Dindo grade 1 to 2 pulmonary infection (7.9%(3/38) vs. 31.6%(12/38), χ²=6.728, P=0.009), total complications (21.1%(8/38) vs. 47.4%(18/38), χ²=5.846, P=0.016) and total lung complications (13.2%(5/38) vs. 42.1%(16/38), χ²=7.962, P=0.005) in the IVMTE group were significantly lower. Conclusion: Inflatable video-assisted mediastinoscopic transhiatal esophagectomy combined with laparoscopic esophagectomy is safe and feasible, which can reach the same range of oncology as thoracoscopic surgery.
