Published in:
01-01-2014 | Original Article
Short-term postoperative superiority and 5-year follow-up outcomes of video-assisted thoracoscopic esophagectomy for treatment of esophageal carcinoma: a historical comparison with conventional open esophagectomy under a single experienced surgeon
Published in: Esophagus | Issue 1/2014
Login to get accessAbstract
Background
Few reports have provided a direct comparison of thoracoscopic and open esophagectomy for treatment of esophageal carcinoma in a sufficiently large number of patients with an adequate follow-up period.
Methods
We compared the short- and long-term (up to 5 years after surgery) outcomes of 121 patients who had undergone video-assisted thoracoscopic esophagectomy with 3-field lymphadenectomy (the VATE group) and 74 patients who had undergone conventional open esophagectomy with 3-field lymphadenectomy (the OE group) for treatment of esophageal squamous cell carcinoma.
Results
Total and intrathoracic operation times were longer and total and intrathoracic blood losses were lower in the VATE group than in the OE group. The number of dissected lymph nodes around the left recurrent laryngeal nerve was significantly higher, while both the intensive care unit stay and postoperative hospital stay were significantly shorter in the VATE group. Moreover, the frequency of postoperative analgesia use was lower in the VATE group. Overall morbidity and mortality rates were similar, and the incidences of overall, surgical-site, and thoracic wound infections were significantly lower in the VATE group. Additionally, the incidence of postoperative pneumonia was also lower in the VATE group, although the difference was not statistically significant. No differences were observed in recurrence or survival rates.
Conclusion
Video-assisted thoracoscopic esophagectomy with 3-field lymphadenectomy is a safe and effective surgical method that can be used as an alternative to conventional open esophagectomy in patients with curable esophageal carcinoma.