Upper Gastrointestinal and Soft Tissue Unit, The University of Queensland, Princess Alexandra Hospital, Ipswich Road, Brisbane, Queensland, Australia.
Expert Rev Gastroenterol Hepatol. 2010 Feb;4(1):91-9. doi: 10.1586/egh.09.62.
Minimally invasive approaches to esophageal resection have been shown to be feasible and safe, with outcomes similar to open esophagectomy. There are no controlled trials comparing the outcomes of minimally invasive esophagectomy (MIE) with open techniques, just a few comparative studies and many single institution series from which assessment of MIE and its present role have been made. The reported improvements from MIE approaches include reduced blood loss, time in intensive care and time in hospital. In comparative studies there is no clear reduction in respiratory complications, although larger series suggest there may be a benefit from MIE. Although MIE approaches report less lymph node retrieval compared with open extended lymphadenectomy, MIE cancer outcomes are comparable with open surgery. MIE will be a major component of the future esophageal surgeons' armamentarium, but should continue to be carefully assessed. There is a role for multicentered studies to prospectively audit outcomes. Large numbers of patients would be required to perform randomized trials of MIE versus open resection.
微创食管切除术已被证明是可行和安全的，其结果与开放食管切除术相似。目前还没有比较微创食管切除术（MIE）与开放技术的结果的对照试验，只有少数比较研究和许多来自单一机构的系列研究，从中可以评估 MIE 及其目前的作用。MIE 方法报告的改进包括减少出血、重症监护时间和住院时间。在比较研究中，呼吸并发症并没有明显减少，尽管较大的系列研究表明 MIE 可能有获益。尽管与开放广泛淋巴结清扫术相比，MIE 方法报告的淋巴结检出较少，但 MIE 的癌症结果与开放手术相当。MIE 将成为未来食管外科医生的主要手段之一，但应继续进行仔细评估。有必要进行多中心研究，前瞻性审核结果。需要大量患者才能进行 MIE 与开放切除的随机试验。
