RESUMEN
ObjectiveTo explore the safety and efficacy of robot-assisted minimally invasive esophagectomy （robot-assisted minimally invasive esophagectomy， RAMIE） and thoracic laparoscopy combined with minimally invasive esophageal resection （minimal invasive esophagectomy， MIE）. MethodsThe data of 188 patients treated with Da Vinci robot assisted minimally invasive esophageal resection （RAMIE） from April 2021 to December 2022 were analyzed. In the RAMIE group， 69 patients， 49 males and 20 female， age （67.2 ± 7.2）； 119 in the MIME group， respectively， 89 males and 30 female， age （69.1 ± 7.0）. At 1 ∶ 1， including 58 patients in the RAMIE group and 58 patients in the MIE group. The t-test， Wilcoxon rank-sum test， χ2 test， and so on. ResultsAfter PSM treatment， the clinical data between the two groups. There was no significant difference in operation time， postoperative tube days， and total number of lymph node dissection between the RAMIE and MIE groups （P <0.05）； the RAMIE group was better in terms of intraoperative bleeding and the MIE group， statistically significant （P <0.05）； the MIE group was better in drainage flow and lymph node dissection for three days （P <0.05）. In terms of postoperative complications， there was no statistical difference between RAMIE and MIE groups （P>0.05）. ConclusionThe recent efficacy of robot-assisted minimally invasive esophagectomy is comparable to that of thoracic laparoscopy and minimally invasive Mckeown esophagectomy； robotic-assisted minimally invasive esophagectomy can reduce intraoperative bleeding and have more advantages in left recurrent laryngeal nerve lymph node dissection.
RESUMEN
@#Objective To investigate the current status of esophageal cancer surgery-related researches using bibliometric methodologies and identify the trend and hotspots. Methods The Chinese and English literature was collected from Web of Science and CNKI from inception of each database to April 1, 2022. VOSviewer 1.6.18 and CiteSpace 6.1 were applied to cluster the authors, institutions, and keywords. For social network and time series analysis, Excel, GraphPad, and R 4.0.3 were used to visualize the literature on esophageal cancer surgery. Results Finally, 19 566 English literature and 19 872 Chinese literature was included. The results demonstrated that the annual publishing of both Chinese and English literature increased over time, with English literature increasing rapidly and Chinese literature maintaining an average number of above 1 000 per year from 2011 to 2019. Researches were predominantly centered in Europe, the United States, Japan, South Korea, and China. China's researches in the field of surgical treatment in esophageal cancer lacked international collaboration, which began later than East Asian countries such as Japan and South Korea and had less influence. From the keyword perspective, previous researches on surgical treatment of esophageal cancer mostly focused on surgical techniques, complications, and comprehensive perioperative therapy. Both Chinese and English literature showed that the prevalence of keywords such as minimally invasive surgery, comprehensive treatment, and clinical trials increased dramatically during the recent years, indicating that these fields may represent the future directions and research trends. Conclusion Compared to East Asia countries, such as Japan and South Korea, Chinese esophageal cancer surgery-related researches are relatively lacking. The research direction and field are similar to those in developed countries such as the United States and Europe. Future attention may be focused on minimally invasive treatment, comprehensive treatment, and clinical trials associated with surgical treatment of esophageal cancer.
RESUMEN
@#Objective To explore the feasibility of decompression without gastric tube after minimally invasive esophageal cancer surgery. Methods Seventy-two patients who underwent minimally invasive esophageal cancer resection at the Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University from 2016 to 2018 were selected as a trial group including 68 males and 4 females with an average age of 58.5±7.9 years, who did not use gastric tube for gastrointestinal decompression after surgery. Seventy patients who underwent the same operation from 2013 to 2015 were selected as the control group, including 68 males and 2 females, with an average age of 59.1±6.9 years, who were indwelled with gastric tube for decompression after surgery. We observed and compared the intraoperative and postoperative indicators and complications of the two groups. Results There were no significant differences between the two groups in operation time, intraoperative blood loss, postoperative level of serum albumin, postoperative nasal jejunal nutrition, whether to enter the ICU postoperatively, death within 30 days after surgery, anastomotic leakage, lung infection, vomiting, bloating or hoarseness (P>0.05). No gastroparesis occurred in either group. Compared with the control group, the recovery time of the bowel sounds and the first exhaust time after the indwelling in the trial group were significantly shorter, and the total hospitalization cost, the incidence of nausea, sore throat, cough, foreign body sensation and sputum difficulty were significantly lower (P<0.05). Conclusion It is feasible to remove the gastric tube for gastrointestinal decompression after minimally invasive esophageal cancer surgery, which will not increase the incidence of postoperative complications, instead, accelerate the postoperative recovery of patients.
RESUMEN
Objective To investigate the effects of ropivacaine infiltration combined with dezo-cine intravenous on stress response during recovery from general anesthesia in patients undergoing e-sophageal cancer surgery.Methods One hundred and forty-four patients of esophageal cancer under-going elective surgery were randomly divided into dezocine group (group D,n = 48 ),ropivacaine group (group R,n =47)and ropivacaine combined with dezocine group (group RD,n =49 ).Before slicing 10 min,patients in group D were taken 20 ml saline infiltration anesthesia (1∶200 000 epi-nephrine),while in group R and group RD were taken 20 ml 0.5% ropivacaine infiltration anesthesia. Patients in the group R were injected intravenously 2 ml saline,while in group D and group RD were injected intravenously 10 mg dezocine 30 min before the end of surgery.Peri-operative bleeding,oper-ation time,recovery time of anesthesia,extubation time and the dosage of propofol and sufentanil of three groups were recorded respectively.At the time points of before induction of anesthesia (T0 ), the end of the surgery (T1 ),removal trachea immediate (T2 ),10 min (T3 )and 30 min (T4 ),the blood pressures and heart rates were recorded,and the serum levels of malondialdehyde (MDA),epi-nephrine (E)and norepinephrine (NE)were detected.Results Recovery time of anesthesia and extu-bation time in group R and group RD were shorter than that in group D significantly (P <0.05).The dosage of propofol and sufentanil in group R and group RD were less than that in group D significantly (P <0.05).Compared with T0 ,SBP in three groups were elevated significantly at T1-T4 (P <0.05), DBP and HR in group D and group R increased significantly at T3 (P <0.05).DBP and HR in group RD at T3 were lower than that in group D and group R significantly (P <0.05).Compared with T0 , the levels of blood sugar,Cor,MDA,E and NE in three groups were elevated significantly at T1-T4 (P <0.05).The levels of blood sugar,Cor,MDA,E and NE in group RD at T1-T4 were lower than that in group D and group R significantly(P < 0.05 ).The incidences of agitation and elevation of blood pressure in group RD were lower than that in group D and group R significantly (P <0.05 ). Conclusion Ropivacaine infiltration combined with dezocine intravenous applied in the esophageal cancer surgery could effectively reduce the stress response during recovery from anesthesia,and de-crease the incidence of agitation.