Abstract:
Objective To explore the security and the radical and clinical value of thoracoscopic-laparoscopic esophagectomy with two-field lymph node dissection for middle esophageal cancer through comparison with open esophagectomy.
Methods A total of 410 stage Ⅱ to stage Ⅲ esophageal cancer patients who underwent two-field lymph node dissection with two different methods (thora-colaparoscopic esophagectomy and open esophagectomy) from January 2009 to July 2013 in Uninon Hospital, Fujian Medical Universi-ty, were analyzed retrospectively. General pathological parameters, operative procedures, and short-term outcomes were collected and compared between the two groups (TLG and OG).
Results No significant differences were found regarding general pathological pa-rameters, such as gender, age, etc. Significant differences between thoracolaparoscopic and open two-field lymph node dissection esoph-agectomy were observed in terms of esophagectomy intraoperative blood loss (206 ± 138) mL vs. (240±111) mL and the mean num-ber of dissected lymph node per person (26.6±8.6)/per vs. (21.7±9.2)/per. Overall postoperative morbidity rate in OG was 35.2%, and its difference from that of TEG (25.8%) is statistically significant (P < 0.05). Regarding single complications, such as pulmonary infec-tion and arrhythmia, OG showed evidently superior results (P < 0.05). Meanwhile, anastomotic stricture and hoarseness rate are higher in TEG (P < 0.05), and the difference was statistically significant as well.
Conclusion Thoracolaparoscopic two-field esophagectomy is technically feasible and safe and can achieve radical tumor resection.