Analysis of postoperative complications for McKeown esophagectomy: minimally invasive versus open esophagectomy

doi:10.3877/cma.j.issn.1674-6899.2016.06.010

Abstract

Abstract:

Objective

To evaluate whether minimally invasive esophagectomy can reduce the incidence of postoperative complications compared with open thoracic surgery.

Methods

A total of 331 patients undergoing the McKeown esophagectomy were included in this study and divided into a thoracoscopic minimally invasive esophagectomy group (MIE group, n=153) and an open thoracic esophagectomy group (OE group, n=178). Postoperative complications were compared between the two groups.

Results

Compared with OE group, MIE group had a less amount bleeding [(123 ± 38)ml vs (346 ± 89)ml, P=0.000], more retrieved lymph nodes[(29.2 ± 6.3) vs (25.5 ± 5.8), P=0.032)], less total postoperative complications (55.6% vs 86.5%, P=0.000) and a lower incidence of pulmonary infection (8.4% vs 20.2%, P=0.003).

Conclusions

This observation study suggests that thoracoscopic minimally invasive esophagectomy can reduce the incidence of postoperative complications, especially better for the incidence of pulmonary infection.

Key words: Thoracic surgery, Minimally invasive esophagectomy, Esophageal carcinoma, Complications

Chao Sun, Weiping Shi, Xiaoxia Lyu, Hui Zou, Yusheng Shu, Shichun Lu, Weiguo Jin, Xiaolin Wang. Analysis of postoperative complications for McKeown esophagectomy: minimally invasive versus open esophagectomy[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2016, 09(06): 354-357.

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URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2016.06.010

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2016/V09/I06/354

Figures/Tables 3

References 15

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项目		MIE组(153例)	OE组(178例)
年龄(岁， ±s)		68.2 ± 11.9	67.9 ± 11.5
性别(男性/女性)(例)		113/40	131/47
肿瘤分期[例(%)]		?	?
?	Ⅰ期	64(41.8)	71(39.9)
?	Ⅱ期	57(37.1)	68(38.2)
?	Ⅲ期	27(17.6)	34(19.1)
?	Ⅳ期	5(3.2)	5(2.8)
肿瘤部位[例(%)]		?	?
?	上段	17(11.1)	18(10.1)
?	中段	103(67.3)	120(67.4)
?	下段	33(21.6)	40(22.5)

项目		MIE组(153例)	OE组(178例)
年龄(岁， ±s)		68.2 ± 11.9	67.9 ± 11.5
性别(男性/女性)(例)		113/40	131/47
肿瘤分期[例(%)]		?	?
?	Ⅰ期	64(41.8)	71(39.9)
?	Ⅱ期	57(37.1)	68(38.2)
?	Ⅲ期	27(17.6)	34(19.1)
?	Ⅳ期	5(3.2)	5(2.8)
肿瘤部位[例(%)]		?	?
?	上段	17(11.1)	18(10.1)
?	中段	103(67.3)	120(67.4)
?	下段	33(21.6)	40(22.5)

组别	例数	手术时间(min)	术中出血量(ml)	清扫淋巴结数目(枚)	清扫双侧喉返神经旁淋巴结数目(枚)	术后住院时间(d)
MIE组	153	214 ± 42	123 ± 38	29.2 ± 6.3	5.1 ± 1.0	14.6 ± 6.3
OE组	178	182 ± 61	346 ± 89	25.5 ± 5.8	4.9 ± 1.0	14.8 ± 6.5
P值	?	0.024	0.000	0.032	0.932	0.792

组别	例数	手术时间(min)	术中出血量(ml)	清扫淋巴结数目(枚)	清扫双侧喉返神经旁淋巴结数目(枚)	术后住院时间(d)
MIE组	153	214 ± 42	123 ± 38	29.2 ± 6.3	5.1 ± 1.0	14.6 ± 6.3
OE组	178	182 ± 61	346 ± 89	25.5 ± 5.8	4.9 ± 1.0	14.8 ± 6.5
P值	?	0.024	0.000	0.032	0.932	0.792

术后并发症	MIE组(153例)	OE组(178例)	P值
发生术后并发症	85(55.6)	154(86.5)	0.000
肺部感染	13(8.5)	36(20.2)	0.003
气胸	3(2.0)	11(6.2)	0.057
气管切开或呼吸机辅助通气	2(1.3)	4(2.2)	0.523
心律失常	13(8.5)	21(11.8)	0.324
肺栓塞	2(1.3)	3(1.7)	0.779
脑梗死	1(0.6)	1(0.6)	0.914
声嘶	10(6.5)	19(10.7)	0.184
永久声嘶	0(0.0)	4(2.2)	0.062
颈部吻合口瘘	16(10.4)	19(10.7)	0.949
吻合口胸腔瘘	4(2.6)	6(3.4)	0.689
食管气管瘘	1(0.6)	0(0.0)	0.280
吻合口狭窄	15(9.8)	18(10.1)	0.926
胃排空障碍	1(0.6)	3(1.7)	0.392
乳糜胸	2(1.3)	3(1.7)	0.779
切口感染	0(0.0)	5(2.8)	0.037
出血再次手术	2(1.3)	1(0.6)	0.476

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