Abstract

Background

Recently, patients with cT4b esophageal cancer often require conversion surgery following induction therapy, for which the standard procedure is open esophagectomy. However, thoracoscopic esophagectomy, including thoracoscopic esophagectomy in the prone position, is increasingly used. We compared short-term outcomes of thoracoscopic esophagectomy and open esophagectomy in this setting.

Methods

We retrospectively analyzed 14 patients who underwent thoracoscopic esophagectomy, and 10 who underwent open esophagectomy, for locally advanced unresectable esophageal cancer after induction therapy between March 2007 and July 2020.

Results

The two groups did not significantly differ in patient background. Median total and thoracic surgical times were both significantly longer for open esophagectomy than for thoracoscopic esophagectomy. Median blood loss was also greater in the open esophagectomy group than in the thoracoscopic esophagectomy group. The thoracoscopic esophagectomy group also had significantly shorter median chest drain duration; and lower C-reactive protein levels on the second and third postoperative days. The two groups did not significantly differ in total complications or postoperative hospital stay.

Conclusions

Thoracoscopic esophagectomy is as safe and feasible as open esophagectomy for conversion surgery after induction therapy for locally advanced unresectable esophageal squamous cell carcinoma.

中文翻译：

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局部晚期不可切除食管鳞癌诱导治疗后中转胸腔镜食管切除术的可行性

摘要

背景

最近，cT4b 食管癌患者在诱导治疗后通常需要进行中转手术，其标准程序是开放性食管切除术。然而，越来越多地使用胸腔镜食管切除术，包括俯卧位胸腔镜食管切除术。我们比较了这种情况下胸腔镜食管切除术和开放性食管切除术的短期结果。

方法

我们回顾性分析了 2007 年 3 月至 2020 年 7 月期间接受胸腔镜食管切除术的 14 名患者和接受开放性食管切除术的 10 名患者，这些患者在诱导治疗后存在局部晚期不可切除的食管癌。

结果

两组患者背景无显着差异。开放性食管切除术的中位总手术时间和胸腔手术时间均显着长于胸腔镜食管切除术。开放性食管切除术组的中位失血量也高于胸腔镜食管切除术组。胸腔镜食管切除术组的中位胸腔引流持续时间也显着缩短；术后第 2 天和第 3 天降低 C 反应蛋白水平。两组在总并发症或术后住院时间方面没有显着差异。

结论

对于局部晚期不可切除的食管鳞癌，在诱导治疗后进行中转手术，胸腔镜食管切除术与开放食管切除术一样安全可行。