[Comparison of Perioperative Outcomes for Esophageal Cancer: Thoracoscopic Versus Thoracotomic Esophagectomy].

Abstract

Background: In our hospital, thoracoscopic surgery in the prone position for esophageal cancer has been performed since 2013. To assess the invasiveness of thoracoscopic esophagectomy in the prone position, we conducted a retrospective observational study after IRB approval.

Methods: After some patients were removed for procedural reasons, 21 patients of thoracoscopic esoph- agectomy (group A, thoracoscopy group) were com- pared with 28 patients with thoracotomic esophagec- tomy (group B, thoracotomy group). We examined : operation time, amount of bleeding, percentage of blood transfused patients, intraoperative fluid balance, length of time from the end of operation to extubation, length of stay in intensive care unit (ICU) and hospital, and long-term intubation rate (> 72 hr).

Results: The thoracoscopy group showed less bleeding (mean, group A, 560 g ; group B, 1,243 g, P< 0.01), a lower percentage of blood transfused patients (group A, 14% ; group B, 64%, P<0.01), lower intra- operative fluid balance (median, group A, 3,046 ml ; group B, 4,215 ml, P<0.05), shorter length of stay in ICU (mean, group A, 2.4days ; group B, 3.7days, P< 0.01) and lower long-term intubation rate (>72 hr) (group A, 0% ; group B, 32%, P<0.01) than those of the thoracotomy group.

Conclusions: This study showed that the thoraco- scopic esophagectomy in the prone position is poten- tially less invasive than thoracotomic surgery. Further study based on a larger number of patients is required to confirm this finding.