Comparative Study Of Minimally Invasive Esophagectomy Versus Open Esophagectomy For Esophageal Carcinoma

ObjectiveTo explore and evaluate the safety,feasibility, oncologic radicality and the short-term outcome of minimally invasive esophagectomy versus open esophageetomy for esophageal cancer.MethodsClinical data were analyzed and compared between 55 consecutive patients who underwent conventional open transthoracic esophagectomy (TTE group:via left thorax) and 34 consecutive patients who underwent minimally invasive esophagectomy (MIE group: Laparoscopic and Thoracoscopic Ivor Lewis Resection) from January 2010 to March 2011. The general information, perioperative conditions, radical treatment of tumor and the recent clinical efficacy were collected and compared between the two groups.ResultsThe gender composition, the age structure and the preoperative complications of the two groups were comparable.The postoperative ICU stay and the postoperative complications were no significant differences from the two groups(P>0.05). But there were significant advantages for MIE among the blood loss, the chest drainage and the days of chest tube placement(P<0.05). The operative time of MIE was longer than the TTE, and the hospital cost of MIE was also higher (p<0.05). No Conversion to open procedure was needed in MIE group. The delayed gastric emptying occurred in 3 patients and the pneumonia occurred in 1 patient in MIE group, but the pneumonia occurred in 4 patients and no delayed gastric emptying occurred in TTE group. In addition, 1 patient got esophageal diaphragmatic herniation and 1 patient got anastomotic leak in TTE group. Pulmonary related complications were higher in the TTE group.The mean number of lymph nodes harvested and the lymph node metastasis rate were no differences from the two groups(Lymph Node: MIE16.88±6.81, TTE14.64±6.53, P>0.05). The mean follow up was 6 months(Range,1 to 14 months).Recurrence rate and survival rate were no significant differences.ConclusionThe minimally invasive esophagectomy for esophageal cancer is safe, feasible, and reliable short-term effect and can achieve radical tumor resection,which may lead to better future of surgical treatment for esophageal carcinoma.