Zhao Yunpeng, Dong Xiaopeng, Cong Bo, Peng Chuanliang, Sun Qifeng, Hao Yingtao, Zhao Xiaogang
Department of Thoracic Surgery, The Second Hospital of Shandong University, Jinan, China.
Thorac Cardiovasc Surg. 2016 Oct;64(7):606-610. doi: 10.1055/s-0035-1570375. Epub 2016 Jan 14.
Thoracoscopic-laparoscopic procedures have been used more in the operations of esophagus cancer; in most times we call it minimally invasive esophagectomy, which is becoming mature. However, the efficacy of minimally invasive esophagectomy is still unclear, especially about the dissection of lymph nodes and survival. A retrospective review was performed. The development process of minimally invasive esophagectomy for esophageal cancer was divided into three stages: the first stage 20, the second stage 37, the third stage 50. Total 107 patients underwent minimally invasive esophagectomy between July 2010 and May 2015. The number of lymph node resected during the three stages increased significantly, with a mean of 12.65, 15.91, and 20.16 nodes, respectively ( = 0.0075). The number of lymph nodes dissection greater than or equal to 12 or 18 increased significantly ( = 0.000). The patients from the first and the second stages had the similar 2-year survival rate ( = 0.8618). There is no significant difference in the 2-year disease-free survival rate ( = 0.606). Surgeons accumulate experience on lymphadenectomy during minimally invasive esophagectomy as time goes by, and experience on 50 to 60 cases is essential and necessary to accomplish an apparent progress.
胸腔镜-腹腔镜手术在食管癌手术中应用得越来越多；大多数时候我们称之为微创食管切除术，这种手术正逐渐成熟。然而，微创食管切除术的疗效仍不明确，尤其是在淋巴结清扫和生存率方面。进行了一项回顾性研究。食管癌微创食管切除术的发展过程分为三个阶段：第一阶段20例，第二阶段37例，第三阶段50例。2010年7月至2015年5月期间共有107例患者接受了微创食管切除术。三个阶段切除的淋巴结数量显著增加，平均分别为12.65个、15.91个和20.16个淋巴结（P = 0.0075）。清扫淋巴结数量大于或等于12个或18个的情况显著增加（P = 0.000）。第一阶段和第二阶段的患者2年生存率相似（P = 0.8618）。2年无病生存率无显著差异（P = 0.606）。随着时间的推移，外科医生在微创食管切除术中积累了淋巴结清扫经验，完成明显进展需要50至60例的经验是必不可少的。
