The Left Breast Minimally Invasive Incision In Clinical Observation In Elderly Patients With Esophageal Cancer Surgery

Objective:To evaluate the feasibility, safety, radicality and the short-term outcome of minimally invasive esophagectomy(MIE) versus open esophagectomy in older pitients with esophageal cancer.Methods:A total of49agedness patients underwent surgery for older esophageal cancer in department of thoracic surgery in heji hospital affiliated of changzhi medical college between September2009and November2010were retrospectively reviewed.17patients underwent minimally invasive esophagectomy(study group) after May2010, while32patients underwent conventional open esophagectomy(control group) before May2010. We evaluated the patients’ operation time, the amount of bleeding in operation, the number of lymph nodes removed, treatments and operative outcomes. Statistical analyses were performed with SPSS Version13.0. Chi-square or T test were used to compare variables. A p value<0.05was considered to be statistically significant.Results:There were no operative deaths in two groups. The operation time was significantly decreased in the study group(157.8±45.2min) compared with the control group(182.4±54.3min). The volume of intraoperative blood loss significantly decreased in the study group(343.7±106.3ml) versus the control group(468.6±123.1ml)(t=-18.26, P=0.001). There were no significant differences between the two groups in Lymph node dissection quantity(9.2±2.4d in the study group and9.8±1.7d in the control group)(P＞0.05).The duration of catheter drainage (84.7±5.5h in the study group and96.6±7.2h in the control group)(t=-8.4, P=0.001),the volume of chest tube drainge (310.6±84.3ml in the study group and446.5±112.6ml in the control group)(t=-16.8, P=0.001), postoperative hospitalized time (9.7±1.8d in the study group and12.8±5.1d in the control group)(t=-4.36, P=0.001) were significantly decreased in the study group compared with the control group.There were no significant differences between the two groups in the degree pain in postoperation(P＜0.05)and short-term postoperative complications (P>0.05).Conclusion:The Minimally invasive esophagectomy which has the features of minimal operation time, a short volume of chest tube drainge, a decrease in postoperative pain and reduced costs is better than conventional open esophagectomy. It is a safe procedure and a suitable alternative option for esophagectomy and may lead to better future of surgical treatment for esophageal carcinoma.