Video-assisted thoracoscopic resection of esophageal carcinomas / 中国微创外科杂志

ABSTRACT

Objective To investigate indications of thoracoscopic resection of esophageal carcinomas. Methods A total of 75 patients with esophageal carcinomas underwent video-assisted thoracoscopic surgery (VATS) from July 1997 to July 2003. The dissection of the esophagus and radical resection of lymph nodes were performed using a right-sided VATS approach. Then the stomach was dissociated through an upper-abdominal incision and was pulled up for esophago-gastric anastomosis in the left neck. Results A conversion to open surgery was required in 3 patients, in 2 of whom the tumors had enroded into the hilum and the posterior wall of the heart, and in 1 of whom the azygous vein was ruptured. The operation time was 160~220 min, with the intrathoracic operation time accounting for 60~90 min. The postoperative blood loss was 300~400 ml. No surgery-related deaths were noted. Postoperative complications included 1 case of volvulus of stomach, 2 cases of anastomotic leakage, 1 case of anastomotic stenosis, and 1 case of chylothorax. Follow-up checkups in 60 patients for 3 months ~ 7 years (mean, 4 years) found 2 cases of supraclavicular lymph node metastasis and 1 case of abdominal lymph node metastasis. The 1-, 3- and 5-year survival rates were 85.0% (51/60), 51.7% (31/60) and 40.0% (24/60), respectively. Conclusions Video-assisted thoracoscopic resection of esophageal carcinomas is feasibly suited to patients with localized lesions at phaseⅠ or Ⅱ.