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[Short-term outcomes of minimally invasive Sweet esophagectomy for Siewert type Ⅱ esophagogastric junction adenocarcinoma].
- Source :
-
Zhonghua wai ke za zhi [Chinese journal of surgery] [Zhonghua Wai Ke Za Zhi] 2016 Jun 01; Vol. 54 (6), pp. 461-465. - Publication Year :
- 2016
-
Abstract
- Objective: To 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. Methods: The 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 χ <superscript>2</superscript> test. Results: The 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%, χ <superscript>2</superscript> =4.063, P =0.044). Conclusion: Minimally invasive technique for Siewert type Ⅱ esophagogastric junction adenocarcinoma can be safely and effectively performed for intrathoracic anastomosis with favorable early outcomes.
- Subjects :
- Adenocarcinoma mortality
Adenocarcinoma pathology
Aged
Blood Loss, Surgical
Esophageal Neoplasms mortality
Esophageal Neoplasms pathology
Esophagogastric Junction pathology
Female
Hospital Mortality
Humans
Lymph Node Excision adverse effects
Lymph Nodes
Lymphatic Metastasis
Male
Middle Aged
Minimally Invasive Surgical Procedures mortality
Neoplasm Staging
Postoperative Complications epidemiology
Retrospective Studies
Treatment Outcome
Adenocarcinoma surgery
Esophageal Neoplasms surgery
Esophagectomy methods
Lymph Node Excision methods
Minimally Invasive Surgical Procedures methods
Subjects
Details
- Language :
- Chinese
- ISSN :
- 0529-5815
- Volume :
- 54
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Zhonghua wai ke za zhi [Chinese journal of surgery]
- Publication Type :
- Academic Journal
- Accession number :
- 27938582
- Full Text :
- https://doi.org/10.3760/cma.j.issn.0529-5815.2016.06.014