Clinical Effect Of Radical Surgery For Esophageal Cancer Under Combined Thoracoscopy And Laparoscopy

Objective: To summarize clinical effect of radical surgery for esophageal cancer under combined thoracoscopy and laparoscopy, and explore treatment and prevention of the postoperative complications.Methods: Retrospective analysis 242 cases of esophageal cancer patients had been accepted the combined thoracoscopy and laparoscopy radical surgery in our department from June 2012 to March 2015, the tumors were located in upper esophagus in 18 cases, middle esophagus in 190,lower in34 cases. Results: This group of surgery except for open conversions in 6cases(2.5%), all successful. The operative time was 210-380 min(mean280.5min), the thoracoscopy time was 60-130 min and laparoscopy time was 40-100 min.The intraoperative blood loss was 150-420ml(mean211.6ml),The harvested lymph nodes were 8-42(mean 16.5),including 10.5lymph nodes in mediastinum and 6 in abdomen.The main postoperative complications: lung infection in 48 cases(19.8%), arrhythmia was observed in 16 cases(6.6%), recurrent laryngeal nerve injury(hoarseness)in 13cases(5.4%), anastomotic leakage was found in 10 cases(4.1%),anastomotic stricture in 7 cases(2.9%)and chylothorax in 6 case(2.5%),all group of no deaths. Followed up for 3 to 33 months, 15 cases of metastatic recurrence, 22 cases of death, the rest to alive. Conclusions:Radical surgery for esophageal cancer under combined thoracoscopy and laparoscopy is technically safe and feasible. With the accumulation of experience in the minimally invasive esophagectomy(MIE), the incidence of postoperative complications may be further decrease.