Original Article
Comparison of postoperative complications between four surgery models in elderly esophageal cancer patients
Qingqing Ding, Lei Xue, Wenyin Zhou, Yibo Xue, Xiao Han, Dandan Yin, Yongqian Shu, Jinhai Tang, Qi Chen, Jinhua Luo
Published 2019-03-14
Cite as Chin J Geriatr, 2019, 38(3): 292-295. DOI: 10.3760/cma.j.issn.0254-9026.2019.03.016
Abstract
ObjectiveTo investigate the surgical methods and the differences of postoperative complications in esophageal cancer patients aged 60 years and over undergoing different operation models.
MethodsA total of 542 elderly esophageal cancer patients who underwent thoracic surgery at our hospital between January 2010 and December 2016 were enrolled. Patients were divided into 4 groups: left thoracic incision operation group (n=202) , Ivor-Lewis two incisions operation group (right chest posterolateral and upper abdomen median) (n=251), three incision operation group (left neck-right chest-abdominal midian (n=29), and McKneown under-endoscope minimally invasive operation group (n=60). Clinical data, including the postoperative days, numbers of lymph nodes dissection, pulmonary infection, serous membrane fluid, arrhythmia, chylous fistula, gastric emptying dysfunction and anastomotic leakage, were retrospectively compared between the four groups.
ResultsThere was no significant difference in the postoperative days, serous membrane fluid, arrhythmia, chylous fistula, gastric emptying dysfunction and anastomotic leakage (P>0.05). The number of lymph nodes dissection in Sweet group, Ivor-Lewis group, Mckeown operation group and minimally invasive Mckneown group were (12.9±7.4)、(19.3±8.6)、(14.3±6.9)and(15.4±7.3)respectively.The number of lymph nodes dissection was more in the Ivor-Lewis group than in the other three groups (F=23.915, P=0.000). Sweet group, Ivor-Lewis group, Mckeown group and minimally invasive Mckneown group were 31.7%、40.2%、24.1% and 50.0% respectively.The incidence of pulmonary infection was higher in the minimally invasive surgery group than in the other three groups (χ2=9.941, P = 0.019).
ConclusionsIvor-Lewis surgery is more effective in lymph nodes dissection and has a lower incidence of complications in elderly esophageal cancer patients.The minimally invasive surgery group has a higher incidence of pulmonary infection than in the other surgical groups, which may be related with the immaturity of endoscopic technique.
Key words:
Esophageal neoplasms; Surgical procedures, operative; Postoperative complications
Contributor Information
Qingqing Ding
Department of Geriatric Oncology, the First Affiliated Hospital, Nanjing Medical University, People's Hospital of Jiangsu Province, Nanjing, 10029, China
Lei Xue
Department of Thoracic Surgery, the First Affiliated Hospital, Nanjing Medical University, People's Hospital of Jiangsu Province, Nanjing, 210029, China
Wenyin Zhou
School of Basic Medical Science, Nanjing Medical University, Nanjing, 211166, China
Yibo Xue
Department of Thoracic Surgery, the First Affiliated Hospital, Nanjing Medical University, People's Hospital of Jiangsu Province, Nanjing, 210029, China
Xiao Han
Department of Geriatric Oncology, the First Affiliated Hospital, Nanjing Medical University, People's Hospital of Jiangsu Province, Nanjing, 10029, China
Dandan Yin
Department of Geriatric Oncology, the First Affiliated Hospital, Nanjing Medical University, People's Hospital of Jiangsu Province, Nanjing, 10029, China
Yongqian Shu
Department of Geriatric Oncology, the First Affiliated Hospital, Nanjing Medical University, People's Hospital of Jiangsu Province, Nanjing, 10029, China
Jinhai Tang
Department of Geriatric Oncology, the First Affiliated Hospital, Nanjing Medical University, People's Hospital of Jiangsu Province, Nanjing, 10029, China
Qi Chen
School of Basic Medical Science, Nanjing Medical University, Nanjing, 211166, China
Jinhua Luo
Department of Thoracic Surgery, the First Affiliated Hospital, Nanjing Medical University, People's Hospital of Jiangsu Province, Nanjing, 210029, China