Conversion to thoracotomy during minimally invasive esophagectomy: Retrospective analysis in a single center
- VernacularTitle:微创食管癌切除术中转开胸的单中心回顾性分析
- Author:
Huilai LV
1
;
Shi XU
1
;
Mingbo WANG
1
;
Zhenhua LI
1
;
Zhao LIU
1
;
Jiachen LI
1
;
Chao HUANG
1
;
Fan ZHANG
1
;
Chunyue GAI
1
;
Ziqiang TIAN
1
Author Information
1. Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, P. R. China
- Publication Type:Journal Article
- Keywords:
Minimally invasive esophagectomy;
conversion to thoracotomy;
reason analysis;
perioperative mortality
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2023;30(06):879-883
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the causes of conversion to thoracotomy in patients with minimally invasive esophagectomy (MIE) in a surgical team, and to obtain a deeper understanding of the timing of conversion in MIE. Methods The clinical data of patients who underwent MIE between September 9, 2011 and February 12, 2022 by a single surgical team in the Department of Thoracic Surgery of the Fourth Hospital of Hebei Medical University were retrospectively analyzed. The main influencing factors and perioperative mortality of patients who converted to thoracotomy in this group were analyzed. Results In the cohort of 791 consecutive patients with MIE, there were 520 males and 271 females, including 29 patients of multiple esophageal cancer, 156 patients of upper thoracic cancer, 524 patients of middle thoracic cancer, and 82 patients of lower thoracic cancer. And 46 patients were converted to thoracotomy for different causes. The main causes for thoracotomy were advanced stage tumor (26 patients), anesthesia-related factors (5 patients), extensive thoracic adhesions (6 patients), and accidental injury of important structures (8 patients). There was a statistical difference in the distribution of tumor locations between patients who converted to thoracotomy and the MIE patients (P<0.05). The proportion of multiple and upper thoracic cancer in patients who converted to thoracotomy was higher than that in the MIE patients, while the proportion of lower thoracic cancer was lower than that in the MIE patients. The perioperative mortality of the thoracotomy patients was not significantly different from that of the MIE patients (P=1.000). Conclusion In MIE, advanced-stage tumor, anesthesia-related factors,extensive thoracic adhesions, and accidental injury of important structures are the main causes of conversion to thoracotomy. The rate varies at different tumor locations. Intraoperative conversion to thoracotomy does not affect the perioperative mortality of MIE.
