Study The Clinical Efficacy Of Thoracoscopic-laparoscopic Esophagectomy And The Value Of Apply Carbon Nanoparticles Mapping Lymph Nodes

Surgery is the preferred and main treatment of Esophageal Cancer (EC), mainlycontents esophageal surgical resection, lymph nodes dissection and reconstruction ofthe gastrointestinal. The traditional Opening Esophagectomy (OE) have serioussurgical trauma, more postoperative complications, high deaths rate and other defects.Minimally Invasive Esophagectomy (MIE) reduce surgical trauma, quicker recovery,fewer complications and other advantages, currently Thoracoscopic-LaparoscopicEsophagectomy (TLE) is more common, but in surgical safety, respect the principlesof surgical oncology and minimally invasive surgical effects remained controversial.Esophageal squamous cell carcinoma mainly through lymphatic metastasis, thoroughcleaning lymph node can reduce the recurrence of metastasis and improve survival.In this study, through a randomized controlled clinical trials, comparativeanalysis the clinical efficacy of Thoracoscopic-Laparoscopic Esophagectomy (TLE)and Opening Esophagectomy (OE). Meanwhile, study the clinical value of pre-operative endoscopic injection of carbon nanoparticles suspension (CNS) besideesophagus tumor mapping lymph nodes in the TLE.Part1A prospective study of the clinical efficacy of TLEObjective: To compare the advantages clinical efficacy of Thoracoscopic-Laparoscopic Esophagectomy (TLE) for Opening Esophagectomy (OE).Methods:232patients with esophageal cancer which respect the requirements wererandomly divided into two groups, including TLE group103cases (excluding the5cases thorough Opening thoracotomy or Opening laparotomy patients), underwentTLE; OE group124cases, underwent traditional OE, after comparing the two groupsof patients with clinical efficacy.Results: The two groups patient’s gender, age, preoperative comorbidities, aspects ofthe biological characteristics of the tumor,histological type, TNM stage, etc. nosignificant difference (P>0.05); TLE group blood loss, postoperative day1pleuralfluid drainage, ICU care time, hospital stay, pain score was significantly lower than the OE group (P <0.05); TLE group patients the number of dissection lymph nodeswith OE group was no difference (P>0.05); TLE group patients postoperativecomplication rate of respiratory was significantly lower than the OE group (P <0.05),but other complications and mortality was no significant difference (P>0.05).Conclusion: Thoracoscopic-Laparoscopic Esophagectomy (TLE) is feasible and safe,respect with the principles of surgical oncology, with minimally invasive treatment.Part2Study the clinical value of carbon nanoparticles suspension mappinglymph nodes in the TLEObjective: To evaluate the clinical value of carbon nanoparticles suspension mappinglymph nodes in the Thoracoscopic-Laparoscopic Esophagectomy (TLE).Methods:40patients with esophageal cancer which respect the requirements wererandomly divided into two groups,including CNS group of20patients, endoscopicinjection of carbon nanoparticles suspension beside esophagus tumors then underwentTLE; other Control group20cases, direct underwent conventional TLE. Observationthe CNS group lymph nodes dye black effect by carbon nanoparticles suspension inCNS group, comparing two groups the number of dissection lymph nodes andpostoperative complications.Results: The degree of CNS dye black on the lymph nodes was78.6%; tumors ofdifferent biological characteristics of the lymph nodes stained black by CNS nodifference (P>0.05), but increases of tumor T staging impact lymph dye black (P<0.05); CNS group the number of dissection lymph nodes was significantly higher (P<0.05); CNS group the degree of lymph node metastasis was significantly higher (P<0.05); CNS group recurrent laryngeal nerve injury was significantly reduced (P<0.05).Conclusion: Carbon nanoparticles suspension with mapping lymph nodes effect, canimprove TLE lymph nodes resection rate, reduce surgical trauma and postoperativecomplications.