Comparative study of perioperative complications and lymphadenectomy between minimally invasive esophagectomy and open procedure

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Author:
MAO Teng(Department of Thoracic Surgery, Shanghai Chest Hospital,Shanghai Jiaotong University, Shanghai 200030, China)
FANG Wen-tao(Department of Thoracic Surgery, Shanghai Chest Hospital,Shanghai Jiaotong University, Shanghai 200030, China)
GU Zhi-tao(Department of Thoracic Surgery, Shanghai Chest Hospital,Shanghai Jiaotong University, Shanghai 200030, China)
YAO Feng(Department of Thoracic Surgery, Shanghai Chest Hospital,Shanghai Jiaotong University, Shanghai 200030, China)
GUO Xu-feng(Department of Thoracic Surgery, Shanghai Chest Hospital,Shanghai Jiaotong University, Shanghai 200030, China)
CHEN Wen-hu(Department of Thoracic Surgery, Shanghai Chest Hospital,Shanghai Jiaotong University, Shanghai 200030, China)
Journal Title:
Chinese Journal of Gastrointestinal Surgery
Issue:
Volume 15, Issue 09, 2012
DOI:
10.3760/cma.j.issn.1671-0274.2012.09.014
Key Word:
Esophageal neoplasms; Esophagectomy; Thoracoscopy; Laparoscopy ;Postoperative complications; Lymph node dissection

Abstract: Objective To analyze the differences in perioperative morbidity and lymph node dissection between minimally invasive esophageal carcinoma resection and open procedure.Methods From January to December 2011,72 patients with esophageal cancer underwent surgery.Thirty-four patients underwent video-assisted esophagectomy,and 38 underwent open procedure.In the minimally invasive group,there were 7 thoracolaparoscopic cases,16 thoracoscopic cases,and 11 laparoscopic cases.Results The early cases (T1-T2) were more common in the minimally invasive group than that in the open group[79.4%(27/34) vs.55.3%(21/38),P<0.05].The complication rate was 41.2%( 11/34) in the open group and 42.1%(16/38) in the minimally invasive group,and the difference was not statistically significant (P>0.05).However,the functional complication in minimally invasive group was significantly lower than that in open group[2.9%(1/34) vs.28.9%( 11/38),P<0.01],while technical complications (anastomotic leak and recurrent laryngeal nerve injury) were significantly more common (38.2% vs.10.5%,P<0.05).Lymph node group number in minimally invasive group was comparable with the open group (9.1 vs.11.2,P>0.05),but the number of node in minimally invasive group was significantly lower (13.5±5.9 vs.17.8±5.2,P<0.05).When stratified by time period,early 17 cases were associated with similar technical complication rate with the late 17 cases (P>0.05),while thoracic lymph node group number,number of node,and positive node were improved in the late phase (all P>0.05).Conclusions Minimally invasive esophagectomy reduces functional morbidity,while technical complication including anastomotic leak and recurrent laryngeal nerve injury may be increased.Endoscopic lymph node dissection may be comparable to open surgery.

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