Original Article
Short-term outcomes of minimally invasive Sweet esophagectomy for Siewert type Ⅱ esophagogastric junction adenocarcinoma
Changqing Liu, Mingran Xie, Mingfa Guo, Xiaohui Sun, Hanran Wu, Xiangxiang Sun, Meiqing Xu
Published 2016-06-01
Cite as Chin J Surg, 2016, 54(6): 461-465. DOI: 10.3760/cma.j.issn.0529-5815.2016.06.014
Abstract
ObjectiveTo describe the technique for minimally invasive Sweet esophagectomy and to evaluate the feasibility, safety and the short-term clinical outcomes of this approach in the treatment of Siewert type Ⅱ esophagogastric junction adenocarcinoma.
MethodsThe clinical data of 122 patients with Siewert type Ⅱ esophagogastric junction adenocarcinoma who received Sweet esophagectomy between October 2013 and June 2015 in Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University was analyzed retrospectively. The study group consisted of 87 men and 35 women, and the ages ranged from 48 to 78 years (median: 67 years). Of those 122 patients, 47 underwent minimally invasive approach and 75 underwent open left transthoracic sweet esophagectomy. This study included 16 stage Ⅰa patients, 35 stage Ⅰb patients, 32 stage Ⅱa patients, 28 stage Ⅱb patients, and 11 stage Ⅲa patients. The clinicopathologic factors, operational factors and postoperative complications of the two groups were compared by t test and χ2 test.
ResultsThe two groups were similar in terms of gender, age, American Society of Anesthesiologists grade, preoperative staging and incidence of comorbidities (P>0.05). The minimally invasive approach was associated with significant increase in the number of total lymph nodes dissected or the stations of the total lymph nodes dissected (18.1±2.7 vs. 15.0±2.5, t= 6.612, P=0.001; 8.9±1.1 vs. 6.7±1.2, t=9.960, P=0.003), significant decrease in surgical blood loss ((88±32) ml vs. (120±34) ml, t=5.052, P=0.001), chest tube duration ((8±4) d vs. (10±4) d, t=3.110, P=0.002) and postoperative stay ((9±5) d vs. (12±4) d, t=3.167, P=0.002) relative to the open approach. The postoperative in-hospital mortality and total morbidity did not differ between the two groups (P>0.05). The minimally invasive approach was associated with significantly fewer respiratory complications than the open approach (8.5% vs. 22.7%, χ2=4.063, P=0.044).
ConclusionMinimally invasive technique for Siewert type Ⅱ esophagogastric junction adenocarcinoma can be safely and effectively performed for intrathoracic anastomosis with favorable early outcomes.
Key words:
Esophageal neoplasms; Thoracoscopy; Laparoscopy
Contributor Information
Changqing Liu
Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University, Hefei 230001, China
Mingran Xie
Mingfa Guo
Xiaohui Sun
Hanran Wu
Xiangxiang Sun
Meiqing Xu
