Fei Yao1, Jian Wang2, Ju Yao1, Lei Xu1, Junling Qian1, Yongke Cao3. 1. Department of Thoracic Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. 2. Department of Thoracic Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. Electronic address: wangjian_428@126.com. 3. College of International Studies, Nanjing Medical University, Nanjing, Jiangsu, China.
Abstract
BACKGROUND: Minimally invasive esophagectomy (MIE) is gaining rapid popularity as an alternative to conventional open esophagectomy. However, whether incorporating laparoscopy into MIE can further help the patients with esophageal cancer has rarely been studied. The aim of this study was to evaluate the short-term clinical efficacy of thoracoscopic-laparoscopic esophagectomy (TLE) compared with thoracoscopic esophagectomy (TE) in treating esophageal cancer. METHODS: From September 2014 to December 2016, a total of 131 patients with esophageal cancer who had consecutively undergone MIE were included in the analysis; of them, TLE was performed in 71 patients and TE in 60 patients. Characteristics and perioperative outcomes of all patients were collected and compared to determine differences between the 2 groups. RESULTS: Operation time (p = 0.172), chest drainage volume (p = 0.656), and pathologic staging (p = 0.671) were similar in the 2 groups. Compared with the TE approach, the TLE approach was associated with less blood loss during the operation (median, 100 vs 150 ml, p < 0.001), shorter chest drainage time (median, 2 vs 3 days, p < 0.001), a larger number of harvested lymph nodes (median, 24 vs 20, p < 0.001), and shorter postoperative hospital stay (median, 10 vs 11 days, p = 0.008). There was no significant difference between groups with regard to the major (grade ≥ III) and minor (grade < III) complications. CONCLUSIONS: TLE is a safe and effective alternative to TE. Patients undergoing TLE may benefit from less blood loss, a larger number of harvested lymph nodes and faster postoperative recovery. Additional randomized controlled trial with longer follow-up is needed.
BACKGROUND: Minimally invasive esophagectomy (MIE) is gaining rapid popularity as an alternative to conventional open esophagectomy. However, whether incorporating laparoscopy into MIE can further help the patients with esophageal cancer has rarely been studied. The aim of this study was to evaluate the short-term clinical efficacy of thoracoscopic-laparoscopic esophagectomy (TLE) compared with thoracoscopic esophagectomy (TE) in treating esophageal cancer. METHODS: From September 2014 to December 2016, a total of 131 patients with esophageal cancer who had consecutively undergone MIE were included in the analysis; of them, TLE was performed in 71 patients and TE in 60 patients. Characteristics and perioperative outcomes of all patients were collected and compared to determine differences between the 2 groups. RESULTS: Operation time (p = 0.172), chest drainage volume (p = 0.656), and pathologic staging (p = 0.671) were similar in the 2 groups. Compared with the TE approach, the TLE approach was associated with less blood loss during the operation (median, 100 vs 150 ml, p < 0.001), shorter chest drainage time (median, 2 vs 3 days, p < 0.001), a larger number of harvested lymph nodes (median, 24 vs 20, p < 0.001), and shorter postoperative hospital stay (median, 10 vs 11 days, p = 0.008). There was no significant difference between groups with regard to the major (grade ≥ III) and minor (grade < III) complications. CONCLUSIONS:TLE is a safe and effective alternative to TE. Patients undergoing TLE may benefit from less blood loss, a larger number of harvested lymph nodes and faster postoperative recovery. Additional randomized controlled trial with longer follow-up is needed.