A Clinical Study Of The VATS Combined With Gasless Laparoscopy Esophagectomy For Esophageal Cancer

OBJECTIVE:It to evaluate the best intrathoracoscopic surgery technique between video-assisted thoracic surgery (VATS) combined with gasless laparoscopy and right open transthoracic esophagectomy, in patients with esophageal cancer.METHODS:From November2006to May2008,we enrolled in this study221patients with an esophageal cancer, prospective randomized in two groups. In111patients we performed the VATS technique (Test group), whereas in the other110patients esophagectomy was adopted by thoracotomy (Control group).RESULTS:Successfully, surgery was performed in both groups. The time consuming of test group was272.3minutes in average with a standard deviation(std) of57.9, and it was218.7minutes in average with std of91.0in the control group(P<0.001). The operative blood loss was219.7±194.4ml in the test group, compared with590.0±324.4ml in the control group, with significant difference (P<0.001). Postoperative hospital stay of test group was9.6±1.7days, and it was11.4±2.3days in the control group(P<0.001). There was nodelayed union of incision in the test group, but6.36%in the control group (P=0.007).0.9%of the test group had disorder of gastric emptying, whereas6.4%of the control group had(P=0.029). There was no significant difference in survival curves and rates (P=0.555)CONCLUSIONS:There were several advantages of VATS technique, such as reduced hemorrhage, better recovery, few complications, and great numer of lymph node dissection, although there was no significant difference intime consuming, and long-term survival rate. Thus the VATS combined with gasless laparoscopy technique was worthy of generalization in esophageal surgery with good prospects.