Minimally invasive esophagectomy for esophageal carcinoma: clinical analysis of 160 cases

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Author:
ZHANG Zhen-ming(Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China)
WANG Yun(Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China)
GAO Yong-shan()
SONG Yu(Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China)
MA Lin(Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China)
Journal Title:
Chinese Journal of Gastrointestinal Surgery
Issue:
Volume 15, Issue 09, 2012
DOI:
10.3760/cma.j.issn.1671-0274.2012.09.017
Key Word:
Esophageal neoplasms; Esophagectomy; Minimally invasive surgery;Thoracoscopy ; Laparoscopy ; Mediastinoscopy

Abstract: Objective To explore the feasibility,safety and clinical application value of minimally invasive esophagectomy(MIE).Methods Clinical data of 160 patients undergoing minimally invasive approach in the West China Hospital of Sichuan University between February 2008 and December 2011 were analyzed retrospectively.Results There were 140 males and 20 females with a mean age of 59.6 years.Approaches to esophagectomy were thoracoscopic and laparoscopic esophagectomy (n =139),thoracoscopic and mediastinoscopic esophagectomy (n =3),laparoscopicassisted Ivor Lewis resection (n=15),thoracolaparoscopic Ivor Lewis resection (n =3).The mean operative time was 364(range 230-780) min and the mean blood loss was 286.2(range 20 to 4000) ml.The tumor free resection margins (R0) were completely in 152 cases (95.0%).The mean lymph node harvested was 19.4 (range 6-39).There were 11 (6.9%) cases converted to open operation including 9 thoracotomy and 2 laparotomy.The intraoperative complication rate was 11.3% (18/160).The average length of intensive care unit (ICU) stay was 22.1 (range 0 to 430) h and the average length of postoperative hospital stay was 13.1 (range 7-93 d).Postoperative complication occurred in 34.4% of patients.The 30-day mortality was 1.2% (2/160) and the overall mortality was 2.5% (4/160).Conclusion MIE is technically feasible and safe for the treatment of esophageal carcinoma,which provides good or even better outcomes than open approach.

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