Clinical Study Of Neoadjuvant Chemoradiotherapy Combined With Thoracoscopic Surgery For Local Advanced Esophageal Cancer

Objective:To evaluate the safety,feasibility and efficacy of neoadjuvant chemoradiotherapy combined with thoracoscopic surgery in the treatment of locally advanced esophageal cancer.Methods The hospital were retrospectively analyzed the records of 70 cases of thoracic surgeons from January 2014 to December 2017 in patients with locally advanced esophageal cancer,27 cases of observation group first two cycles of cisplatin plus paclitaxel chemotherapy regimens(TP),and synchronous radiation therapy,stay 3 weeks after completion of neoadjuvant chemoradiotherapy followed thoracoscope esophageal cancer radical surgery;The other 43 patients were treated with thoracoscopic surgery after pathological diagnosis.Both the observation group and the control group were treated with single cavity endotracheal intubation combined with intravenous anesthesia,and the artificial pneumothorax was used to support the radical operation of esophageal carcinoma and regional lymph node dissection.The differences in surgical excision rate,number of lymph nodes,lymph node metastasis and postoperative anastomotic fistula and pulmonary infection were compared between the two groups.Results The patients in the observation group successfully completed 2 cycles of neoadjuvant chemotherapy plus radiotherapy before operation,and no serious side effects of radiotherapy and chemotherapy were observed.Both groups achieved the open esophageal and esophagogastric stomach anastomosis without laparoscopy.Thecure rates of the observation group and the control group were 92.6% and 88.4% respectively,the rates of lymph node metastasis were 55.5% and 62.8%,respectively,and the rates of lymph node metastasis were 12.6% and 14.7% respectively(p <0.05).The incidences of postoperative complications were 40.7% and 39.5% respectively,with no significant difference(P = 0.920).Conclusions For locally advanced esophageal cancer patients,the use of neoadjuvant chemoradiotherapy combined thoracoscope surgery compared with surgery alone,can reduce tumor clinical stage,significantly improve the cure rate,decrease the local recurrence rate and regional lymph node metastasis rate,and does not increase the postoperative complications such as anastomotic fistula,the incidence of pulmonary infection,etc.Adopt preoperative neoadjuvant chemoradiation joint surgery in patients with locally advanced esophageal cancer is a kind of safe and effective comprehensive treatment plan.