An Analysis Of The Short-term Outcomes On Thoracoscopic-laparoscopic Esophagectomy And Open Esophagectomy For Esophageal Cancer

Objective: To compare with the difference of the process of surgical operation and complications after surgery between the thoracoscopic-laparoscopic esophagectomy(TLE)and open esophagectomy(OE)for esophageal cancer,and to explore the value of thoracoscopic-laparoscopic esophagectomy for esophageal cancer.Methods: From April 2014 to January2017,clinical data of patients with esophageal cancer surgery were studied retrospectively at the Department of Thoracic Surgery,Affliated Hospital of Zunyi Medical College.TLE was performed for a group of 46 patients,which was compared with a group of 84 cases of OE.Eventually,33 paired cases,matched using propensity-score matching,were selected for further statistical analysis.Results: Compared with the OE group,the TLE group had less blood loss(125.8±93.6ml vs 239.4±118.4ml,P<0.05);shorter postoperative hospital stay(11.8d[7-22d])vs 19.3d[11-35d],P<0.05);similar lymph node harvest(22.5±9.4 vs 20.3±5.1,P=0.125),the intensive-care unit stay(1.6d[1-10d] vs 1.7 d [1-12 d],P=0.86),perioperative mortality(3% vs 3%,P=1)and major complications(39% vs 55%,P=0.218).However,the TLE group had longer operation duration(353.9±80.9min vs306.5±88.1min,P<0.05)than the OE group,and the TLE group was associated with significantly fewer pulmonary(15% vs 39%,P<0.05)and wound(9% vs 36%,P<0.05)infection than the OE group.Conclusion: TLE and OE can achieve similar effection.TLE has advantages in intraoperative bleeding,postoperative pulmonary and wound infection and postoperative hospital stay,which deserve popularization dramaticly.