A Study Of Minimally Invasive Esophagectomy (MIE) And Open 3-incision Esophagectomy For Esophageal Carcinoma

Objective: Minimally invasive surgery(MIE), with its advantages of minimal trauma, less pain and better outcomes, has become the main stream of the development of surgery. This study compared the differences in postoperative complications and quality of life between MIE and 3-incision esophagectomy for cancer.Methods: Fifity patients with esophageal cancer were recruited in this study: Twenty-five patients underwent MIE and the others underwent 3-incision esophagectomy for cancer in the Department of thoracic surgery, the Fourth Hospital of Hebei Medical University. Preoperative conditions, amount of bleeding, lymph node dissection condition, body temperature, heart rate, drainage volume, pain after the operations, peripheral blood leucocyte count, time of postoperative drainage tube placement and fasting time, complications and postoperative follow-up were recorded. All the data were analyzed by SPSS23.0. The inspection level was set at a=0.05. P value less than 0.05(P<0.05) was considered as statistical difference.Results:1 There were no statistical differences in age and sex between two groups(P>0.05).2 There were no statistical differences in the numbers of dissected lymph nodes(P>0.05), but the intraoperative bleeding in MIE group was far less than that in the open esophagectomy group(P<0.001).3 There were significantly differences in body temperature and the heart rate in 72 hours after surgery between the 2 groups(P<0.05), but not in drainage volume, anastomotic fistula, respiratory failure, recurrent laryngeal nerve paralyses and peripheral blood leucocyte count( P > 0.05), The application of analgesia in MIE group was less than that in the open esophagectomy group(P<0.05), but there was no difference in time of postoperative drainage tube placement and fasting time(P>0.05).4 There was no significant difference in reflux symptom at postoperative visits between the 2 groups(P>0.05).Conclusion: MIE has the same result on oncological resection as open surgery, however MIE has the advantages on less bleeding during intraoperative, less traumas and less pain. Its surgical risk is obviously decreased than open esophagectomy, which was worthy of promoting.