Application Of Endoscopic In Esophageal Carcinoma Surgery

Objective: Summarizing the application ofendoscopic in esophageal carcinoma surgery, and comparing the clinical data of Endoscopic resection of esophageal cancer with the traditional Right thoracotomy esophagectomy and traditional left thoracotomy esophagectomy to investigate the therapeutic effect of endoscopic in esophageal carcinoma surgery.Materials and methods: In our hospital surgical oncology,clinical data of 96 patients with esophageal carcinoma patients from December 2013 to December 2015 were Collected. They were treated by the same group of doctors.Among them,31 cases received endoscopic resection(Endoscopic group EG),6 cases were converted to thoracotomy,17 cases received the traditional right thoracotomy esophagectomy(Right thoracotomy group RTG),42 cases received the traditional left thoracotomy esophagectomy(Left thoracotomy group LTG).The preoperative,intraoperative and postoperative indexes were analyzed to explore the therapeutic effect of endoscopic in esophageal carcinoma surgery.Results:There were no perioperative deaths.The operative time of EG was 6.94±1.38 hours.The operative time of RTG was 6.68±1.54 hours.The operative time of LTG was 5.30±0.86 hours.The operative time of EG and RTG was no significant difference(P> 0.05).But it was longer than LTG and the difference was statically significant(P<0.05).Intraoperative blood lose of EG was 319.35±193.94 ml.Inraoperative blood loss of RTG and LTG respectively were 176.47±120.05 ml and 302.38±78.05 ml.Intraoperative blood lose of EG and LTG were no significant difference(P> 0.05).However,it was longer than RTG and the difference was statistically significant(P<0.05).By comparing EG and RTG,the average number of total lymph nodes removed,metastatic nodes and The number of cases of arrhythmia were lower than RTG and the difference was statistically significant(P<0.05).There were no significant difference in the number of cases of intraoperative blood transfusion,the time of chest tube indwelling,the time of stomach retention,the time of liquid diet after operation,ICU rotation,the time of our department after operation,pathological stage,depth of invasion,lymph node staging(pN stage),the total number of complications,pulmonary infection, pleural effusion, pneumothorax, respiratory failure,ARDS,anastomotic leak between two groups(P> 0.05).By comparing EG and LTG,the depth of invasion was lower than LTG,but the number of cases of pneumothorax was higher than LTG.The difference was statistically significant(P<0.05).There were significant difference in the number of cases of intraoperative blood transfusion,the time of chest tube indwelling,the time of stomach retention,the time of liquid diet after operation,ICU rotation,the time of our department after operation,pathologic stage,the average number of total lymph nodes removed,metastatic nodes, lymph node staging(pN stage), the total number of complications,pulmonary infection,pleuraleffusion,respiratory failure,ARDS, anastomotic leak between two groups(P>0.05).Three groups did not occur Chylothorax after operation.The number of cases in the event of pnemothorax or pieural effusion underwent closed thoracic drainage or thoracentesis were no significant difference(P> 0.05).Conclusion: 1.Endoscopic technique is safe and feasible. in the early and mid esophageal cancer surgery 2.The depth of cleaning lymph node is still insufficient.3.The number of part ofpostoperative complicationsafter endoscopic surgery were less in the early stage.4.The develop of endoscopic technique in the early stage is basis of the accumulation of experience in traditional thoracotomy.5.The long-term effect of endoscopic resection of esophageal cancer need to be followed up.