Ikeguchi Masahide, Fukumoto Yoji
Chirurgia (Bucur). 2016 Jul-Aug;111(4):313-7.
Thoracoscopic esophagectomy has been introduced to reduce postsurgical pulmonary complications in patients with esophageal squamous cell carcinomas (ESCCs). However, the survival benefit of this procedure has not been well examined. In the present study, we retrospectively investigated the clinical outcomes of thoracoscopic esophagectomy in patients with operable thoracic ESCCs.
Eighty-four patients were enrolled in this study. They were diagnosed with resectable clinical stage I-III thoracic ESCCs and underwent thoracic esophageal resection with three-field lymph node dissection at Tottori University Hospital between January 2007 and December 2013. Occurrence of postoperative complications, disease-free survival (DFS) and overall survival (OS) were compared between the open thoracotomy group and the thoracoscopic esophagectomy group.
Fifty-one patients underwent the thoracoscopic method, while 38 underwent the open method. Morbidity was 42.9% and mortality was 2.4%. The thoracoscopic method showed a lower occurrence of postoperative pulmonary complications. The 5-year DFSs of the two groups were not different. However, the 5-year OS of patients in the thoracoscopic method group was superior to that of those in the open method.
Thoracoscopic esophagectomy for thoracic ESCCs is technically feasible and the low rate of postoperative pulmonary complications may prolong the OS of patients.
胸腔镜食管切除术已被引入以减少食管鳞状细胞癌（ESCC）患者术后肺部并发症。然而，该手术的生存获益尚未得到充分研究。在本研究中，我们回顾性调查了可手术的胸段ESCC患者胸腔镜食管切除术的临床结局。
本研究纳入了84例患者。他们被诊断为可切除的临床I-III期胸段ESCC，并于2007年1月至2013年12月在鸟取大学医院接受了胸段食管切除术及三野淋巴结清扫术。比较了开胸手术组和胸腔镜食管切除术组术后并发症的发生情况、无病生存期（DFS）和总生存期（OS）。
51例患者采用胸腔镜手术方法，38例采用开胸手术方法。发病率为42.9%，死亡率为2.4%。胸腔镜手术方法术后肺部并发症的发生率较低。两组的5年DFS无差异。然而，胸腔镜手术方法组患者的5年OS优于开胸手术组。
胸腔镜食管切除术治疗胸段ESCC在技术上是可行的，术后肺部并发症发生率低可能会延长患者的OS。
