Clinical Analysis of 38 Patients with Esophageal Carcinoma Undergoing Toracoscopic and Laparoscopic Esophagectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YUXin ¹ ,  LIUYi ¹ , DUMing ² , WANGYi-lin ¹ , XIANGShu ¹

1. Department of Toracic Surgery, Central Hospital of Chongqing Tree Gorges, Chongqing 404000, P. R. China;
2. Department of Cardiothoracic Surgery, Te First Afliated Hospital of Chongqing Medical University, Chongqing 400042, P. R. China;

Corresponding?author：

LIUYi, Email: liuyi_cq@yeah.net

Keywords：

Esophageal carcinoma; Thoracoscope; Laparoscope; Mimally invasive surgery

DOI：

10.7507/1007-4848.20150122

Video：

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Objective To summarize the clinical experience of thoracoscopic and laparoscopic esophagectomy for esophageal carcinoma. Method We retrospectively analyzed the clinical data of 38 patients with esophageal carcinoma undergoing thoracoscopic and laparoscopic esophagectomy in Central Hospital of Chongqing Three Gorges between March 2011 and March 2013. There were 25 males and 13 females aged 64.25±7.68 years (ranged 45-79 years). The esophagus was freed and the lymph nodes were cleaned under the thoracoscope in the left lateral position. Then the stomach was freed under laparoscope and lifted up to anastomose with the esophagus through the passageway behind the sternal bone. Results All surgical process progressed successfully without intraoperative death or major hemorrhage. The total operating time ranged from 250 to 340 minutes. The intraoperative hemorrhage ranged from 80 to 350 ml. The number of lymph nodes cleaned ranged from 7 to 15 (10.24±2.04) and a total of 8 patients were found of tumor metastasis. Postoperative stage grading indicated 8 patients of T₁N₀M₀, 16 patients of T₂N₀M₀, 5 patients of T₂N₁M₀, 6 patients of T₃N₀M₀ and 3 patients of T₃N₁M₀. Postoperative complications included chylothorax in 1 patient, pulmonary infection in 4 patients, and cervical anastomotic leakage in 4 patients. All 38 patients were followed up for 3 to 12 (6.31±2.18) months, and 1 patient was lost. Two patients died from cervical anastomotic leakage resulting in chest infection. The other all achieved recoveries without metastatic or recurrence of tumor. Conclusion The intraoperative and postoperative complications of thoracoscopic and laparoscopic esophagectomy for esophageal carcinoma are less frequently than traditional surgery, so it's worthy of promotion in large regional general hospitals.

Citation： YUXin, LIUYi, DUMing, WANGYi-lin, XIANGShu. Clinical Analysis of 38 Patients with Esophageal Carcinoma Undergoing Toracoscopic and Laparoscopic Esophagectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(5): 467-470. doi: 10.7507/1007-4848.20150122 Copy

1.	赫捷, 邵康.中國食管癌流行病學現狀、診療現狀及未來對策.中國癌癥雜志, 2011, 21(7):501-504.
2.	Kawakubo H, Takeuchi H, Kitagawa Y. Current status and future perspectives on minimally invasive esophagectomy. Korean J Torac Cardiovasc Surg, 2013, 46(4):241-248.
3.	Luketich JD, Alvelo-Rivera M, Buenaventura PO, et al. Minimally invasive esophagectomy:outcomes in 222 patients. Ann Surg, 2003, 238(4):486-494, discussion 494-485.
4.	姚曉軍, 張洪偉, 鄭興龍, 等.全胸腹腔鏡聯合手術治療食管癌的療效分析.中國胸心血管外科臨床雜志, 2013, 20(6):686-690.
5.	Baccari P, Castoldi R, Bisagni P, et al. Minimally invasive esophagectomy for adenocarcinoma of the lower esophagus and the gastroesophageal junction. Suppl Tumori, 2005, 4(3):S129.
6.	Palanivelu C, Prakash A, Senthilkumar R, et al. Minimally invasive esophagectomy:thoracoscopic mobilization of the esophagus and mediastinal lymphadenectomy in prone position——experience of 130 patients. J Am Coll Surg, 2006, 203(1):7-16.
7.	楊楠蘭.電視胸腹腔鏡聯合與傳統開胸下食管癌切除術后患者生活質量的比較.齊齊哈爾醫學院學報, 2010, 31(4):521-522.
8.	趙文棟.胸腹腔鏡聯合應用對食管癌患者CRP和生活質量的影響.中國實用醫藥, 2013, 8(14):35-36.
9.	熊宏超, 吳楠, 陳晉峰, 等.腹胸兩切口加兩野淋巴結清掃治療胃食管交界部癌的臨床研究.中華醫學雜志, 2007, 87(21):1478-1481.
10.	Akiyama H, Tsurumaru M, Udagawa H, et al. Radical lymph node dissection for cancer of the thoracic esophagus. Ann Surg, 1994, 220(3):364-372.
11.	Fujita H, Kakegawa T, Yamana H, et al. Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer. Comparison of three-field lymphadenectomy with two-field lymphadenectomy. Ann Surg, 1995, 222(5):654-662.
12.	沈亮, 王永旺, 仲崇俊.胸腹腔鏡聯合食管癌切除與傳統手術的對比分析.中華腔鏡外科雜志(電子版), 2013, 6(2):122-125.
13.	Cadiere GB, Torres R, Dapri G, et al. Toracoscopic and laparoscopic oesophagectomy improves the quality of extended lymphadenectomy. Surg Endosc, 2006, 20(8):1308-1309.
14.	陳保富, 朱成楚, 馬德華, 等.胸、腹腔鏡聯合手術治療食管癌.中國微創外科雜志, 2009, 9(8):707-708, 711.
15.	Bonavina L, Laface L, Abate E, et al. Comparison of ventilation and cardiovascular parameters between prone thoracoscopic and Ivor Lewis esophagectomy. Updates Surg, 2012, 64(2):81-85.
16.	Zou YB, Yan H, Liu XH, et al. Lateral position could provide more excellent hemodynamic parameters during video-assisted thoracoscopic esophagectomy for cancer. Surg Endosc, 2013, 27(10):3720-3725.
17.	Fabian T, Martin J, Katigbak M, et al. Thoracoscopic esophageal mobilization during minimally invasive esophagectomy:a head-tohead comparison of prone versus decubitus positions. Surg Endosc, 2008, 22(11):2485-2491.
18.	譚黎杰, 王群, 馮明祥, 等.一種新的食管切除法——俯臥位胸腔鏡食管切除術(附8例報告).中國臨床醫學, 2009, 16(5):720-721.
19.	Zhu ZJ, Zhao YF, Chen LQ, et al. Clinical application of layered anastomosis during esophagogastrostomy. World J Surg, 2008, 32(4):583-588.
20.	方文濤, 陳文虎, 范利民, 等.食管癌切除術后不同重建途徑吻合口瘺的原聞及預防.中華胃腸外科雜志, 2005, 8(3):217-219.
21.	杜銘, 陳煥文, 吳慶琛, 等.胸腔鏡聯合腹腔鏡食管癌切除術治療40例食管癌的臨床分析.第三軍醫大學學報, 2010, 32(7):722-724.

1. 赫捷, 邵康.中國食管癌流行病學現狀、診療現狀及未來對策.中國癌癥雜志, 2011, 21(7):501-504.
2. Kawakubo H, Takeuchi H, Kitagawa Y. Current status and future perspectives on minimally invasive esophagectomy. Korean J Torac Cardiovasc Surg, 2013, 46(4):241-248.
3. Luketich JD, Alvelo-Rivera M, Buenaventura PO, et al. Minimally invasive esophagectomy:outcomes in 222 patients. Ann Surg, 2003, 238(4):486-494, discussion 494-485.
4. 姚曉軍, 張洪偉, 鄭興龍, 等.全胸腹腔鏡聯合手術治療食管癌的療效分析.中國胸心血管外科臨床雜志, 2013, 20(6):686-690.
5. Baccari P, Castoldi R, Bisagni P, et al. Minimally invasive esophagectomy for adenocarcinoma of the lower esophagus and the gastroesophageal junction. Suppl Tumori, 2005, 4(3):S129.
6. Palanivelu C, Prakash A, Senthilkumar R, et al. Minimally invasive esophagectomy:thoracoscopic mobilization of the esophagus and mediastinal lymphadenectomy in prone position——experience of 130 patients. J Am Coll Surg, 2006, 203(1):7-16.
7. 楊楠蘭.電視胸腹腔鏡聯合與傳統開胸下食管癌切除術后患者生活質量的比較.齊齊哈爾醫學院學報, 2010, 31(4):521-522.
8. 趙文棟.胸腹腔鏡聯合應用對食管癌患者CRP和生活質量的影響.中國實用醫藥, 2013, 8(14):35-36.
9. 熊宏超, 吳楠, 陳晉峰, 等.腹胸兩切口加兩野淋巴結清掃治療胃食管交界部癌的臨床研究.中華醫學雜志, 2007, 87(21):1478-1481.
10. Akiyama H, Tsurumaru M, Udagawa H, et al. Radical lymph node dissection for cancer of the thoracic esophagus. Ann Surg, 1994, 220(3):364-372.
11. Fujita H, Kakegawa T, Yamana H, et al. Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer. Comparison of three-field lymphadenectomy with two-field lymphadenectomy. Ann Surg, 1995, 222(5):654-662.
12. 沈亮, 王永旺, 仲崇俊.胸腹腔鏡聯合食管癌切除與傳統手術的對比分析.中華腔鏡外科雜志(電子版), 2013, 6(2):122-125.
13. Cadiere GB, Torres R, Dapri G, et al. Toracoscopic and laparoscopic oesophagectomy improves the quality of extended lymphadenectomy. Surg Endosc, 2006, 20(8):1308-1309.
14. 陳保富, 朱成楚, 馬德華, 等.胸、腹腔鏡聯合手術治療食管癌.中國微創外科雜志, 2009, 9(8):707-708, 711.
15. Bonavina L, Laface L, Abate E, et al. Comparison of ventilation and cardiovascular parameters between prone thoracoscopic and Ivor Lewis esophagectomy. Updates Surg, 2012, 64(2):81-85.
16. Zou YB, Yan H, Liu XH, et al. Lateral position could provide more excellent hemodynamic parameters during video-assisted thoracoscopic esophagectomy for cancer. Surg Endosc, 2013, 27(10):3720-3725.
17. Fabian T, Martin J, Katigbak M, et al. Thoracoscopic esophageal mobilization during minimally invasive esophagectomy:a head-tohead comparison of prone versus decubitus positions. Surg Endosc, 2008, 22(11):2485-2491.
18. 譚黎杰, 王群, 馮明祥, 等.一種新的食管切除法——俯臥位胸腔鏡食管切除術(附8例報告).中國臨床醫學, 2009, 16(5):720-721.
19. Zhu ZJ, Zhao YF, Chen LQ, et al. Clinical application of layered anastomosis during esophagogastrostomy. World J Surg, 2008, 32(4):583-588.
20. 方文濤, 陳文虎, 范利民, 等.食管癌切除術后不同重建途徑吻合口瘺的原聞及預防.中華胃腸外科雜志, 2005, 8(3):217-219.
21. 杜銘, 陳煥文, 吳慶琛, 等.胸腔鏡聯合腹腔鏡食管癌切除術治療40例食管癌的臨床分析.第三軍醫大學學報, 2010, 32(7):722-724.

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Clinical Analysis of 38 Patients with Esophageal Carcinoma Undergoing Toracoscopic and Laparoscopic Esophagectomy

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