The Advantage And Clinical Application Of Right Thoracal Single Incision In The Treatment Of Mid-Thoracic Esophageal Cancer

Objective To compare the short-term effect of right thoracal single incision and right thoracal upper abdominal double incisions in the treatment of mid-thoracic esophageal cancer, and to investigate the advantage and clinical application of right thoracal single incision subtotal esophagectomy for squamous cell cancer.Methods The study is based on the review and analysis of the clinical data of 25 cases of mid-thoracic esophogeal cancer who received right thoracal single incision in Qilu Hospital of Shandong University from Oct.2007 to Oct.2009. The 25 cases include 5 cases of PT2N0M0,8 cases of PT3N0M0,7 cases of PT2N1Mo, and 5 cases PT3N1M0. The other group of 25 cases were used right thoracal and upper abdominal double incisions approach, including 5 cases of PT2N0M0,9 cases of PT3N0M0,5 cases of PT2N1M0, and 6 cases PT3N1M0. All the patients underwent subtotal esophagectomy for mid-thoracic esophagus squamous cancer with the stomach being used for reconstruction. Summing up the clinical and pathological features, comparing the operation time, the bloodloss, the number of the lymph nodes cleaning, the incidence of postoperative complications and survival rate between the two groups. SPSS 13.0 software package was used for statistical data processing. Measurement data was used independent sample t-test, and count information was used chi-square test. P value of less than 0.05 was for the significant difference.Results The difference of the clinical and pathological features of the two groups of cases was not significant. There were no post-operative death in the two groups, but notable differences are identified in operation time(P<0.05). Compared with the 2-incision group, the single incision group needs shorter time for operation. The single incision group also has lower incidence rate of anhelation and arhythmia after the operation, but the differenes are not obvious. And no obvious differenes are found between the two groups in the bloodloss, the number of the lymph nodes cleaning, chest drainage, postoperative anastomosis leakage, recurrent laryngeal nerve injury, chylothorax, and the survival rate (P>0.05).Conclusions The radical correction of esophageal carcinoma via right thoracal single incision demonstrates better short-term curative effects for the patients of mid-thoracic esophageal cancer without pT4 diasease or widely lymph node metastasis. It shortened the operation time, reduced the risk of damage and minimized the chances of anhelation and arhythmia. Therefore, it is well worth developing and promoting.