A retrospective cohort comparison of esophageal carcinoma between thoracoscopic and laparoscopic esophagectomy and open esophagectomy / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To study the efficacy and safety of thoracoscopic and laparoscopic esophagectomy for esophageal carcinoma.</p><p><b>METHODS</b>Based on hospitalization data from March 2011 to March 2014, 62 cases of esophageal carcinoma treated with thoracoscopic and laparoscopic esophagectomy (minimally invasive group, with 45 male patients) and other 62 cases treated with open esophagectomy (open esophagectomy group, with 45 male patients) were analyzed in a retrospective cohort. The mean age of two groups were (62±9) years and (62±8) years, respectively. Quantitative data were analyzed using t-test, whereas qualitative variables were tested with χ2 test. There were no significant difference in age, tumor location, pathological type, tumor staging between two groups (P>0.05). Perioperative data and three-year clinic outcome were collected. The three-year survival curve were calculated with the Kaplan-Meier method and compared by the log-rank test between the two groups.</p><p><b>RESULTS</b>Compared with open esophagectomy group, minimally invasive group has less amount of bleeding during operations ((231±40) ml vs. (302±37) ml, t=4.63, P=0.000), pleural drainage after operations ((490±41) ml vs. (1 090±43) ml, t=-79.59, P=0.000), and postoperative hospital stay ((16±4) days vs. (17±4) days, t=-2.61, P=0.010). Meanwhile, minimally invasive group has more operation time ((272±39) minutes vs. (242±45) minutes, t=3.97, P=0.000) and total and thoracic cavity retrieved lymph nodes (30±5 vs. 28±4, t=2.39, P=0.018; 15±4 vs. 14±3, t=2.59, P=0.011). Nineteen and 31 patients had postoperative complications and statistical significance difference was found between two groups (χ2=4.83, P=0.028). The three-year survival rate was 73.2% in minimally invasive group and 71.4% in open esophagectomy group. There was no significance difference between two groups (χ2=0.170, P>0.05).</p><p><b>CONCLUSION</b>Thoracoscopic and laparoscopic esophagectomy had the advantages of amount of bleeding, postoperative hospital stay and complications, and had the same three-year survival rate with open esophagectomy.</p>