| ObjectiveEsophagectomy for esophageal cancer(EC) is a complex operation with a huge trauma, and it induces a lot of complications and high mortality. Minimally invasive esophagectomy(MIE) is the development trend as a result of small trauma and quick recovery. The present study was aimed to investigate the clinical outcomes of three filed minimally invasive esophagectomy(TMIE) compared to traditional open esophagectomy(OE). Method1.The clinical data of 205 cases of esophagectomy on patients in The Fourth Military Medical University Xijing Digestive Hospital and Tangdu Hospital from January 2010 to December 2010 received esophagectomy were retrospectively analyzed. The patients were divided into three field minimally invasive esophagectomy group(TMIEG) and open esophagectomy group(OEG). The general information, postoperative pathological examination results, surgery information, postoperative complications and 5 years survival rate were statistical analysised.2.The patients diagnosised of EC and received esophagectomy in The Fourth Military Medical University Xijing Digestive Hospital and Tangdu Hospital from January 2010 to December 2010 were followed up. The clinical data and qulity of life of the patients survival for alive more 3 years were retrospective analysised. Results1.There were no significant differences of general data including sex, age, preoperative smoker, tumor location, preoperative diet and comorbidity between the groups(P> 0.05). Postoperative pathologic data showed no difference of histology types and clinical stage(P> 0.05). Operation time and number of lymph node harvested of patients in TMIEG were higher than those in OEG but blood loss and postoperative hospital stay were lower(P< 0.05). Results of postoperative complications showed that wood infection and overall heart-pulmonary complications decreased significantly in patients of TMIEG compared to OEG(P< 0.05). Five year survival period of patients in TMIEG was longer than OEG.(P= 0.002).2.For patients survival period more than 3 years, There were no significant differences of general data between the groups but N stage(P> 0.05). The number of lymph node harvested and metastasis lymph node of patients in TMIEG was higher than those in OEG but blood loss and postoperative hospital stay were lower(P< 0.05). There was no significant difference of postoperative complications among groups(P> 0.05). The results of follow up quality of life showed that physical function, emotional function, dysphagia, eating, reflux, nausea and vomiting in patients in TMIEG were better than those in OEG 3 years after operation(P< 0.05). Conclusion1. Morbidity and mortality following TMIE for EC are acceptable. Compared to OE, patients received TMIE show decreased blood loss, postoperative hospital duration, complication and morbidity as well as prolonged survival.2. TMIE improve long term outcomes of patients. Quality of life in patients of TMIEG is better than that of OE 3 years after operation. |
