A Retrospective Study On The Therapeutic Effect Of Thoracoscope-assisted And Mediastinoscope-assisted Esophagectomy

Objective To compare the clinical efficacies of mediastinoscope-assisted and thoracoscope-assisted esophagectomy.Methods Seventy-six patients with esophageal cancer who underwent minimally invasive esophagectomy at the Hospital of Ningxia Medical University General Hospital between June 2015 and January 2019 were retrospectively evaluated.Among them,28 patients underwent mediastinoscope-assisted transhiatal esophagectomy(MATHE),and 48 received thoracoscope-assisted transthoracic esophagectomy(TATTE).According to the mode of operation,the patients were divided into thoracoscopy group and mediastinoscopy group.The general data and perioperative clinical data of each patient were collected to compare the clinical efficacy of two different surgical methods,and 76 patients were followed up.The effects of two surgical methods on the survival rate and long-term postoperative complications of esophageal cancer were compared to evaluate the safety and effectiveness of the MATHE procedure.Results All operations were successful in thoracoscopy group and mediastinoscopy group.MATHE was favorable in terms of operation time,intraoperative blood loss,drainage volume 3 days after surgery and postoperative hospital stay(P < 0.05).Lymph node dissections were less than those in the TATTE(P < 0.05).all of the postoperative complications studied only the incidence of hypoproteinemia was lower than that in the TATTE group(P < 0.05).However,there was no significant difference in the incidence of complications such as pulmonary infection,recurrent laryngeal nerve injury and anastomotic leakage(P > 0.05).Finally,the incidence of postoperative lung infection and long-term complications was similar between the two groups(P > 0.05).The survival curves of the two groups intersected,but the downward trend of MATHE was slower.Conclusion TATTE and MATHE are both technically safe and feasible for esophageal cancer.MATHE has the advantages of minimal trauma,shorter operation time,less intraoperative blood loss,and faster recovery.More adequate tumor clearance in terms of lymph node dissection can be achieved with TATTE.However,the comparison of survival rates between the 2 groups is similar.