Comparision Of Clinical Study For Thoracolaparoscopic And Open Three Field Radical Esophagectomy Of Esophageal Carcinoma

Objective To evaluate the security,feasibility and clinical value of thoracolaparoscopic esophagectomy and three field lymphadenectomy of esophageal carcinoma by comparing with open esophagectomy.Methods Clinical data of 381 patients with esophageal carcinoma who underwent esophagectomy with three field lymphadenectomy from June 2012 to December 2014 were retrospectively analyzed. Among the 381 patients,207 cases received thoracolaparoscopic esophagectomy and three field lymphadenectomy(thoracolaparoscopic group),174 cases received open esophagectomy(open group).Clinical characteristics,the number of lymph nodes harvested and perioperative complications were compared between the two groups.Results There were significant differences between thoracolaparoscopic esophagectomy and three field lymphadenectomy and open esophagectomy in operation duration [(233.01± 50.51)min vs. (257.99±53.53)min, P<0.001], blood loss [(192.48±57.60) ml vs. (240.67±78.51) ml,P<0.001], hospital stay [(14.47±5.32) days vs. (29.45±11.00) days, P=0.001], the total number of lymph node [(45.01±15.94) vs. (29.45 ± 11.01), P< 0.001], the number of mediastirial lymph node [(17.19±8.21) vs. (11.07±5.65), P< 0.001], the number of upper mediastinal lymph node [(6.97±4.80) vs. (4.36±3.34), P< 0.001], the number of middle and lower mediastinal lymph node [(10.22±5.23) vs. (6.72 ±4.23),P<0.001], the number of abdominal lymph node [(19.37±9.36) vs. (9.99± 5.73), P<0.001] and pulmonary complications (13.04% vs.23.56%,P=0.008). No significant differences were observed in the number of cervical lymph node, the number of mediastinal lymph node, anastomotic leakage, recurrent laryngeal nerve injury, arrhythmia, chest bleeding, chylothorax delayed gastric emptying and perioperative mortality( all P> 0.05).Conclusion thoracolaparoscopic esophagectomy and three field lymphadenectomy of esophageal carcinoma is safe and feasible and is associated with shorter operative time,less blood loss,shorter hospital stay and less pulmonary complications.