Comparison Of Perioperative Complication And Result Of Operation Between Thoracoscopic Esophagectomy(TE) And Open Three‐file Esophaesophagectomy(OE) For Aged Patients With Esophageal Cancer

Objective:To contrast and analyze the clinic efficacy between thoracoscopic esophagectomy(TE) and open three-file esophagectomy(OE) for aged patients with esophageal cancer.Methods:The clinicai data of 88 patients older than 60 years and suffering with esophageal cancer who accepted TE(n=43) or OE(n=45) from August 2012 to August 2014 were retrospectively collected and compared.Analyze the differences including operative time 、 blood loss 、 number of lymph node dissection 、complication and the time of hospitalization after operation.Results:There were no operative death in all.And four cases in TE were converted to thoracotomy,which were not included in the statistical analysis after operation. No significant differences were observed in the average number of lymph nodes [(21.61±5.54):(20.00±6.54),P>0.05] and blood loss[(221.79±29.90)ml:( 280.67±36.25)ml,P>0.05].There were statistical differences between TE and OE in operative time and the time of hospitalization after operation. The operative time of TE group was [(318.54±67.26)min :(274.80±30.38)min,P<0.01] more than OE group.And the time of hospitalization after operation was[(10.77±1.55)d:(11.80±1.53)d,P<0.05] less than OE group.The rate of recurrent nerve injury had no statistical difference between two groups[4例(10.26%):4例(8.89%),P=0.831].But incidence of atrial fibrillation for drug control was [4例(10.25%):13例(28.89%),P=0.034]less than OE group,incidence of lung infection was[7例(17.9%):18例(40.0%),P=0.027] also less than OE group,incidence of cervical anastomotic leakage was [1(2.7%):2(4.4%),P=0.039]less than OE group,There were statistical differences between TE and OE in arrhythmia、lung infection and cervical anastomotic leakage.Conclusion:Compared with OE,TE has the advantages of smaller incision、early recovery.Not only can achieve the same effect of lymph node dissection,but also can reduce lung infection and arrhythmia for aged patients with esophageal cancer.Although the operative time of TE group was longer than OE group.Maybe because the application of TE started later than OE,and the cavity mirror surgical technology was not mature enough.with the cumulation of operative experience,the operative time of TE will be less and less.So TE will set out its advantages gradually.