Comparison Of Minimally Invasive And Open Thoracic Surgery For Ivor Lewis Esophageal Carcinoma Through Right Thoracic And Abdominal Incisions

Objective Esophageal cancer is one of the most common malignant tumors in thoracic surgery.Conventional open surgery is of great trauma high postoperative complications and long recovery time.With the development of endoscopy technology,minimally invasive surgery for esophageal cancer has been widely applied year by year.Compared with traditional surgery,whether it can achieve corresponding therapeutic objectives and whether it has advantages.The purpose of this study was to compare minimally invasive and open thoracic surgery for Ivor Lewis esophageal cancer through right thoracic and abdominal incisions,and to discuss the feasibility,safety and possible advantages of minimally invasive Ivor Lewis surgery.Methods A retrospective study was conducted on the clinical data of 48 patients who underwent esophageal cancer surgery through right thoracotomy and abdominal incision from January 2016 to December 2018.The preparation of gastric dissection and tubular stomach was completed under the open epigastric midline incision,and the patients were divided into two grovps A and B according to the situation of chest surgery.In group A,chest minimally invasive incision+upper abdominal median incision was opened;in group B,chest incision-upper abdominal median incision was opened.There was no difference in postoperative treatment and management.Collect patients' general information and operation time,intraoperative blood loss,number of the lymph node the chest,laryngeal recurrent nerve injury,chyfothorax,anastomotic fistula and postoperative pain score three days ago,postoperative bed time,postoperative hospitalization days,cardiac complications such as postoperative pulmonary complications,data to sum up,compare the differences between groups.Results The whole operation was completed successfully.There was no significant difference in gender,age and other general data between the two groups(P>0.05).Operation time[(160.3 22.3)min vs(168.9 23.6)min],intraoperative blood loss[(170.348.6)ml vs(182.3 50.2)ml],number of thoracoperitonal lymph node dissection[(18.611.9 vs(17.8 10.2)pieces],postoperative days of hospitalization[(10.0 1.8)days vs(11.22.1)days],There were no statistically significant differences(P>0.05)between the minimally invasive group and the open grouy in terms of VAS scores[(3.69 1.01)points vs.(6.23 1.39)points],postoperative activity time[(1.1 0.5)days vs.4.3 0.8)days,and postoperative complications(P<0.05),The minimally invasive group was significantly superior to the open group.Conclusion Ivor Lewis minimally invasive thoracic surgery through right thoracic and abdominal incisions for esophageal cancer can achieve the therapeutic effect of open surgery in most patients,which is technically feasible and can be confirmed to be safe through studies,but requires certain surgical experience and skills.The postoperative pain of minimally invasive thoracic patients was significantly reduced,the time of getting out of bed was earlier,and the incidence of pulmonary complications was significantly reduced,all of which had obvious advantages over open surgery.However,patients with tumor invasion or dense adhesbn with aorta and trachea were timely transferred to open.