Clinical Research Of Two Surgical Approaches For Esophageal Carcinoma In The Middle Section

Objective:To evaluate the advantages and disadvantages of two surgical approaches, the left thoracal single incision and the right thoracal and upper abdominal incisions in the treatment of the Middle thoracic esophageal carcinoma, so as to provide theoretical basis to select a suitable operation. Methods:Review235Middle thoracic esophageal carcinoma cases which received operation from March,2003to Novmber,2011. Divided them into two groups,110cases with left posterolateral thoracotomy incision (single incision) and125with right thoracal and upper abdominal incisions (double incisions). Summing up the clinical and pathological features, compared the operative time, the number of the lymph nodes cleaning, the incidence of postoperative complications, upper esophageal positive margin rate, length of stay and thoracic cavity drainage tube indwelling time between the two groups. Results:The difference of the clinical and pathological features of the two groups of cases was not significant. Two groups’ data in the operation time, the number of the lymph nodes cleaning and length of stay was significant difference(p<0.01); the data in thoracic cavity drainage tube indwelling was not significant. Compared with the double incisions group, the single incision group has lower incidence rate of pulmonary complications, delayed gastric emptying and wound liquefaction(were10.0%/12.8%,14.5%/16.0%,2.7%/6.4%), but has the higher incidence rate of chylothorax, anastomotic leakage, anastomotic stricture, recurrent laryngeal nerve injury(were2.7%/1.6%,2.7%/0.8%,3.64%/1.6%,3.6%/2.4%) Conclusion:Two surgical approaches all can achieve radical resection. Compared to the two groups we can see the single incision group has advantages of shorter operative time, less invasive, recovering quickly of patients, shorter length of stay. The double incisions group has advantages in the exposure of the operative field and the number of the lymph nodes cleaning. Two groups have no significant diferences in the incidence of perioperative complications.