Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
General Surgery, Torbat-e- Heydariyeh University of Medical Sciences, Torbat-e-Heydariyeh, Iran.
Asian Cardiovasc Thorac Ann. 2021 Jan;29(1):33-37. doi: 10.1177/0218492320963976. Epub 2020 Sep 30.
This study aimed to evaluate the results of transhiatal esophagectomy using a mediastinoscope in comparison with conventional transhiatal esophagectomy.
Sixty-two esophageal cancer patients who were referred to our thoracic surgery clinic between April 2015 and March 2017, and met the inclusion criteria, were randomly divided into two groups of 31 each. In the first group, patients were operated on by conventional transhiatal esophagectomy. In the second group, only release of the thoracic esophagus through a neck incision (mediastinal esophagolysis) was performed using a mediastinoscope. The other surgical procedures were similar to those in the first group.
The mean age of the patients was almost the same in both groups (57.7 years in the first group versus 56.7 years in the second group). There was no significant difference in sex ratio. The mean volume of blood loss during the operation, mean operative time, and intensive care unit stay as well as cardiopulmonary complications and early postoperative complications were lower in the group that had esophagectomy using a mediastinoscope, and the number of resected mediastinal lymph nodes was greater.
Based on the results of this study, it can be expected that use of a video mediastinoscope for esophagolysis of the thoracic esophagus in a transhiatal esophagectomy procedure is safe and it will reduce the morbidity and mortality in these patients.
本研究旨在评估使用纵隔镜经胸骨后入路食管切除术与传统经胸骨后入路食管切除术的结果。
2015 年 4 月至 2017 年 3 月期间，共有 62 例食管癌患者被收入我院胸外科，并符合纳入标准，将其随机分为两组，每组 31 例。第一组患者接受传统经胸骨后入路食管切除术，第二组仅通过颈部切口（纵隔食管松解术）使用纵隔镜行胸段食管松解。其他手术步骤与第一组相同。
两组患者的平均年龄几乎相同（第一组 57.7 岁，第二组 56.7 岁）。两组患者的性别比例无显著差异。纵隔镜组术中出血量、手术时间、重症监护病房停留时间以及心肺并发症和早期术后并发症均较低，切除的纵隔淋巴结数量也较多。
基于本研究结果，可以预期使用视频纵隔镜行经胸骨后入路食管切除术的胸段食管松解术是安全的，可降低这些患者的发病率和死亡率。
