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01-04-2018

Low invasiveness of thoracoscopic esophagectomy in the prone position for esophageal cancer: a propensity score-matched comparison of operative approaches between thoracoscopic and open esophagectomy

Authors: Shinsuke Kanekiyo, Shigeru Takeda, Masahito Tsutsui, Mitsuo Nishiyama, Masahiro Kitahara, Yoshitaro Shindo, Yukio Tokumitsu, Shinobu Tomochika, Yoshihiro Tokuhisa, Michihisa Iida, Kazuhiko Sakamoto, Nobuaki Suzuki, Shigeru Yamamoto, Shigefumi Yoshino, Shoichi Hazama, Tomio Ueno, Hiroaki Nagano

Published in: Surgical Endoscopy | Issue 4/2018

Abstract

Background

In this study, cytokine levels, outcome, and survival rates after esophagectomy for esophageal cancer were retrospectively investigated in a propensity score-matched comparison of operative approaches between the thoracoscopic esophagectomy (TE) in the prone position and open esophagectomy (OE).

Patients and Methods

Between 2005 and 2014, TE was performed on a group of 85 patients, which was compared with a group of 104 OE cases. Eventually, 65 paired cases were matched using propensity score matching.

Results

Although the TE group underwent a significantly longer operation time than the OE group (P < 0.001), the TE group exhibited less blood loss (P < 0.001) and had a shorter postoperative hospital stay (P = 0.038) than the OE group. The serum interleukin-6 levels on ICU admission (P < 0.001) and on POD 1 (P < 0.001) were significantly lower in the TE group. The interleukin-10 levels on ICU admission (P < 0.001), POD 1 (P = 0.016), and POD 3 (P < 0.001) were also significantly lower in the TE group. Pulmonary complication was significantly lower in the TE group (P = 0.043). The 5-year PFS rates in the TE and OE groups were 70.6 and 58.7% (P = 0.328), respectively, and OS rates were 64.9 and 50.2% (P = 0.101), respectively.

Conclusion

TE compared to OE is a less invasive procedure with lower surgical stress and less pulmonary complication for the treatment of esophageal squamous cell carcinoma.

Cancer Registry and Statistics. Cancer Information Service NCC, Japan. http://ganjoho.jp/public/index.html

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Title: Low invasiveness of thoracoscopic esophagectomy in the prone position for esophageal cancer: a propensity score-matched comparison of operative approaches between thoracoscopic and open esophagectomy
Authors: Shinsuke Kanekiyo
Shigeru Takeda
Masahito Tsutsui
Mitsuo Nishiyama
Masahiro Kitahara
Yoshitaro Shindo
Yukio Tokumitsu
Shinobu Tomochika
Yoshihiro Tokuhisa
Michihisa Iida
Kazuhiko Sakamoto
Nobuaki Suzuki
Shigeru Yamamoto
Shigefumi Yoshino
Shoichi Hazama
Tomio Ueno
Hiroaki Nagano
Publication date: 01-04-2018
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 4/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-017-5888-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Low invasiveness of thoracoscopic esophagectomy in the prone position for esophageal cancer: a propensity score-matched comparison of operative approaches between thoracoscopic and open esophagectomy

Abstract

Background

Patients and Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and Methods

Results

Conclusion

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