Babic B, Schiffmann L M, Schröder W, Bruns C J, Fuchs H F
Klinik und Poliklinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland.
Chirurg. 2021 Apr;92(4):299-303. doi: 10.1007/s00104-020-01337-x. Epub 2021 Jan 11.
Thoracoabdominal esophagectomy still plays a major role in the oncological treatment for esophageal cancer. Minimally invasive procedures were developed to reduce the high rate of postoperative morbidity and mortality without negatively affecting the oncological outcome.
What evidence supports minimally invasive oncological surgery of the esophagus? Do patients benefit from minimally invasive esophagectomy compared to an open approach? Is the reduction of surgical access trauma specifically advantageous?
Review, evaluation and critical analysis of the international literature.
A reduction in postoperative morbidity by decreasing surgical trauma was confirmed by three prospective randomized clinical trials, while showing at least similar oncological outcomes. Diverse retrospective analyses and meta-analyses also came to the same result.
A minimization of surgical access trauma during thoracoabdominal esophagectomy reduces postoperative morbidity compared to conventional open surgery. Recent evidence suggests that oncological outcomes are not altered depending on the surgical approach.
胸腹联合食管癌切除术在食管癌的肿瘤治疗中仍发挥着重要作用。微创技术的发展旨在降低术后高发病率和死亡率，同时不负面影响肿瘤治疗效果。
有哪些证据支持食管微创肿瘤手术？与开放手术相比，患者是否能从微创食管切除术中获益？手术入路创伤的减少是否具有特别的优势？
对国际文献进行综述、评估和批判性分析。
三项前瞻性随机临床试验证实，通过减少手术创伤可降低术后发病率，同时显示出至少相似的肿瘤治疗效果。各种回顾性分析和荟萃分析也得出了相同的结果。
与传统开放手术相比，胸腹联合食管癌切除术中手术入路创伤的最小化可降低术后发病率。最新证据表明，肿瘤治疗效果不会因手术方式而异。
