Yulong Hou1, Wei Guo, Zhijian Yang, Jianqiang Zhao. 1. Department of Cardiothoracic Surgery, Huai'an First People's Hospital, Nanjing Medical University, Jiangshu Huai'an 223300, China. hyllymhly@163.com.
Abstract
OBJECTIVE: To investigate the feasibility and safety of 3D laparoscopic and thoracoscopic esophagectomy. METHODS:From October 2013 to March 2014, 154 patients with esophageal cancer of clinical stage T3N1M0 undergoing 3D or 2D minimally invasive esophagectomy in lateral prone position in our department were enrolled prospectively, and randomly divided into 3D group (78 cases) and 2D group (76 cases). The esophagus was dissociated by 3D or 2D laparoscope and thoracoscope to the entry of thorax. Stomach was dissociated by same telescopes and cut linearly. After tube stomach shaping was completed, esophagogastric anastomosis was performed in the left neck. The operative safety and short-term efficacy were compared between the two groups. RESULTS: The entire procedure was technically successful in 154 patients. The average total operative time in 3D group was shorter than that in 2D group [(176.0±27.7) min vs. (203.0±31.5) min, P<0.05]. No significant differences were observed in blood loss [(124.0±35.8) ml vs. (127.0±25.7) ml], number of harvested lymph node (17.0±8.6 vs. 18.0±3.3), postoperative hospital stay [(11.8±9.3) d vs. (12.6±8.8) d] (all P>0.05), and morbidity of postoperative complication [12.8% (10/78) vs. 14.5% (11/76)]. The median follow-up time was 5.6 (3-8) months and 5.2 (5-7) months in 3D and 2D groups respectively, and no death or relapse cases were found during the follow-up. CONCLUSION:3D laparoscopic and thoracoscopic esophagectomy under lateral prone position is technically feasible and safe for esophageal carcinoma, as compared to 2D procedure.
RCT Entities:
OBJECTIVE: To investigate the feasibility and safety of 3D laparoscopic and thoracoscopic esophagectomy. METHODS: From October 2013 to March 2014, 154 patients with esophageal cancer of clinical stage T3N1M0 undergoing 3D or 2D minimally invasive esophagectomy in lateral prone position in our department were enrolled prospectively, and randomly divided into 3D group (78 cases) and 2D group (76 cases). The esophagus was dissociated by 3D or 2D laparoscope and thoracoscope to the entry of thorax. Stomach was dissociated by same telescopes and cut linearly. After tube stomach shaping was completed, esophagogastric anastomosis was performed in the left neck. The operative safety and short-term efficacy were compared between the two groups. RESULTS: The entire procedure was technically successful in 154 patients. The average total operative time in 3D group was shorter than that in 2D group [(176.0±27.7) min vs. (203.0±31.5) min, P<0.05]. No significant differences were observed in blood loss [(124.0±35.8) ml vs. (127.0±25.7) ml], number of harvested lymph node (17.0±8.6 vs. 18.0±3.3), postoperative hospital stay [(11.8±9.3) d vs. (12.6±8.8) d] (all P>0.05), and morbidity of postoperative complication [12.8% (10/78) vs. 14.5% (11/76)]. The median follow-up time was 5.6 (3-8) months and 5.2 (5-7) months in 3D and 2D groups respectively, and no death or relapse cases were found during the follow-up. CONCLUSION: 3D laparoscopic and thoracoscopic esophagectomy under lateral prone position is technically feasible and safe for esophageal carcinoma, as compared to 2D procedure.