Evaluation of safety of video-assisted thoracoscopic esophagectomy for esophageal carcinoma

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Author:
WANG Hao(Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China)
TAN Li-jie(Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China)
LI Jing-pei(Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China)
SHEN Ya-xing(Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China)
ZHANG Yi(Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China)
FENG Ming-xiang(Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China)
WANG Qun(Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China)
Journal Title:
Chinese Journal of Gastrointestinal Surgery
Issue:
Volume 15, Issue 09, 2012
DOI:
10.3760/cma.j.issn.1671-0274.2012.09.015
Key Word:
Esophageal neoplasms ; Esophagectomy ; Thoracoscopy ; Safety

Abstract: Objective To explore the safety of video-assisted thoracoscopic esophagectomy for esophageal carcinoma.Methods From January 2005 to March 2012,260 patients with esophageal carcinoma received thoracoscopic esophagectomy(TE group),while 322 patients underwent conventional open esophagectomy (OE group).Operative procedures,perioperative complications,reoperation,readmission to intensive care unit (ICU),and perioperative mortality were compared between the two groups.Results Compared with OE group,TE group possessed less thoracic operative time[ (105±30)min vs.( 112±41 ) min,P=0.000],less blood loss[(95±48) ml vs.(107±44) ml,P=0.002],shorter postoperative hospital stay [(14.3±7.5) d vs.(16.9±9.5) d,P=0.000]and more lymph node harvest from thorax[(13.5±5.0) vs.(11.6±4.7),P=0.000].The total perioperative complication rate was lower in TE group than that of OE group (34.6% vs.45.0%,P=0.011),as well as perioperative mortality (0.8% vs.3.4%,P=0.032).Lower rate of readmission to ICU (5.4% vs.10.6%,P=0.024) was found in the TE group as compared to the OE group,while the reoperation rate was comparable (1.5% vs.2.5%,P=0.425).Conclusion Thoracoscopic esophagectomy is advantageous than open procedure in terms of surgical safety.

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