Fabian T, Martin J T, McKelvey A A, Federico J A
Hospital of St. Raphael, New Haven, Connecticut, USA.
Dis Esophagus. 2008;21(3):220-5. doi: 10.1111/j.1442-2050.2007.00783.x.
Surgical resection of the esophagus remains the mainstay of treatment for esophageal cancer. However, esophagectomy is associated with significant morbidity and mortality in the postoperative period. We have recently altered our practice pattern to include minimally invasive esophagectomy (MIE) as the approach of choice in the hope of minimizing morbidity associated with this procedure. In this retrospective analysis, we compare outcomes of our first year performing MIE to the previous 3 years of open esophagectomy (OE) at a single teaching hospital. Sixty-five patients underwent esophagectomy between June 2002 and July 2006. Among these, 22 patients underwent MIE between June 2005 and July 2006 and 43 patients underwent OE. The two groups were comparable with regards to age, comorbidities and pathologic stage. The MIE group had less operative blood loss (178 mL vs. 356 mL), decreased respiratory complications requiring mechanical ventila-tion (5% vs. 23%), increased number of lymph nodes procured per procedure (15 vs. 8), and increased number of patients discharged within 10 days (72% vs. 28%) when compared to the OE group. No difference was identified in mortality, complications, or length of stay.
食管外科切除术仍然是食管癌治疗的主要手段。然而，食管切除术在术后会伴有显著的发病率和死亡率。我们最近改变了治疗模式，将微创食管切除术（MIE）作为首选方法，以期将该手术相关的发病率降至最低。在这项回顾性分析中，我们比较了在一家教学医院开展MIE的第一年与此前三年开放食管切除术（OE）的结果。2002年6月至2006年7月期间，65例患者接受了食管切除术。其中，22例患者于2005年6月至2006年7月期间接受了MIE，43例患者接受了OE。两组在年龄、合并症和病理分期方面具有可比性。与OE组相比，MIE组术中失血量更少（178 mL对356 mL），需要机械通气的呼吸并发症减少（5%对23%），每次手术获取的淋巴结数量增加（15个对8个），10天内出院的患者数量增加（72%对28%）。在死亡率、并发症或住院时间方面未发现差异。
