Short-term Outcomes of Thoracoscopic and Laparoscopic-assisted Minimally Invasive McKeown Procedure for EsophagealCancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SONG Yu , WANG Yun , ZHANG Zhenming.

Department of Thoracic Surgery，West China Hospital，SichuanUniversity，Chengdu 610041，P. R. China;

Corresponding author：

Keywords：

Esophageal cancer; 　Thoracoscopy; 　Laparoscopy; 　Minimally invasive

DOI：

10.7507/1007-4848.20130211

Video：

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Objective To explore clinical application values of thoracoscopic and laparoscopic-assisted minimally invasive McKeown procedure for esophageal cancer. Methods Clinical data of 196 patients with esophageal cancer （EC） who underwent thoracoscopic and laparoscopic-assisted minimally invasive McKeown procedure in West China Hospital of Sichuan University from February 2008 to August 2012 were analyzed retrospectively. There were 145 male and 51 female patients with their age of 40-76 （58.8±6.6） years. There were 43 patients with EC in the upper segment of the esophagus, 115 patients with EC in the middle segment of the esophagus and 38 patients with EC in the lower segment of the esophagus.Results Total operation time was 215-780 （305.0±40.7） minutes，including thoracoscopic operation time of 50-580 （105.0±38.4） minutes and laparoscopic operation time of 28-105 （54.0±8.6） minutes. Intraoperative blood loss was 20-440 （285.4±38.5） ml. The number of dissected lymph nodes was 6-39 （20.4±1.6） for each patient. Postoperative hospital stay was 7-93 （12.8±5.2） days. Sixty patients （30.6%） had postoperative complications，including 28 patients （14.3%） with pulmonary comp-lications，5 patients （2.5%） with chylothorax，5 patients （2.5%） with arrhythmias，15 patients （7.6%） with anastomotic fistula，10 patients （5.0%） with recurrent laryngeal nerve injury，and other complications in 2 patients. Conclusion Thoracoscopic and laparoscopic-assisted minimally invasive McKeown procedure is a safe and feasible operation for esophageal cancer.

Citation： SONG Yu,WANG Yun,ZHANG Zhenming.. Short-term Outcomes of Thoracoscopic and Laparoscopic-assisted Minimally Invasive McKeown Procedure for EsophagealCancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2013, 20(6): 683-685. doi: 10.7507/1007-4848.20130211 Copy

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3.	Peracchia A， Rosati R， Fumagalli U， et al. Thoracoscopic esopha-gectomy：are there benefits ? Semin Surg Oncol， 1997， 13 （4）：259-262.
4.	Chui PT， Mainland P， Chung SC， et al. Anaesthesia for three-stagethoracoscopic oesophagectomy：an initial experience. AnaesthIntensive Care， 1994， 22 （5）：593-596.
5.	Law S， Fok M， Chu KM， et al. Thoracoscopic esophagectomy for esophageal cancer. Surgery， 1997， 122 （1）：8-14.
6.	游宾，李辉，侯生才，等. 胸腹腔镜联合食管癌切除食管胃胸内吻合术的初步临床应用. 中国胸心血管外科临床杂志， 2012， 19 （6）：624-628.
7.	van der Sluis PC， Ruurda JP， van der Horst S， et al. Robot-assisted minimally invasive thoraco-laparoscopic esophagectomy versus open transthoracicesophagectomy for resectable esophageal cancer， a randomized controlled trial （ROBOT trial）. Trials， 2012， 13：230.
8.	Cuesta MA， Biere SS， Henegouwen MI， et al. Randomised trial， Minimally Invasive Oesophagectomy versus open oesophagectomy for patients with resectable oesophageal cancer. J Thorac Dis， 2012， 4 （5）：462-464.
9.	Bailey SH， Bull DA， Harpole DH， et al. Outcomes after esophagectomy：a ten-year prospective cohort. Ann Thorac Surg， 2003， 75 （1）：217-222.
10.	Dantoc MM， Cox MR， Eslick GD. Does Minimally Invasive Esopha-gectomy （MIE） provide for comparable oncologic outcomes to open techniques ? A systematic review. J Gastrointest Surg， 2012， 16 （3）：486-494.
11.	Gao Y， Wang Y， Chen L， et al. Comparison of open three-field and minimally-invasive esophagectomy for esophageal cancer. Interact Cardiovasc Thorac Surg， 2011， 12 （3）：366-369.
12.	Ben-David K， Rossidis G， Zlotecki RA， et al. Minimally invasive esophagectomy is safe and effective following neoadjuvant chemoradiationtherapy. Ann Surg Oncol， 2011， 18 （12）：3324-3329.
13.	Biere SS， Cuesta MA， van der Peet DL. Minimally invasive versusopen esophagectomy for cancer：a systematic review and meta-analysis. Minerva Chir， 2009， 64 （2）：121-133.
14.	AtKins BZ， Shah AS， Hutcheson KA， et al. Reducing hospital morbidity and mortality following esophagectomy. Ann Thorac Surg， 2004， 78 （4）：1170-1176.
15.	Sgourakis G， Gockel I， Radtke A， et al. Minimally invasive versus open esophagectomy：meta-analysis of outcomes. Dig Dis Sci， 2010， 55 （11）：3031-3040.

1. 　Swanson SJ， Sugarbaker DJ. The three-hole esophagectomy. The Brigham and Women's Hospital approach （modified McKeown technique）. Chest Surg Clin N Am， 2000， 10 （3）：531-552.
2. 　Luketich JD， Schauer PR， Christie NA， et al. Minimally invasive esophagectomy. Ann Thorac Surg， 2000， 70 （3）：906-912.
3. 　Peracchia A， Rosati R， Fumagalli U， et al. Thoracoscopic esopha-gectomy：are there benefits ? Semin Surg Oncol， 1997， 13 （4）：259-262.
4. 　Chui PT， Mainland P， Chung SC， et al. Anaesthesia for three-stagethoracoscopic oesophagectomy：an initial experience. AnaesthIntensive Care， 1994， 22 （5）：593-596.
5. 　Law S， Fok M， Chu KM， et al. Thoracoscopic esophagectomy for esophageal cancer. Surgery， 1997， 122 （1）：8-14.
6. 　游宾，李辉，侯生才，等. 胸腹腔镜联合食管癌切除食管胃胸内吻合术的初步临床应用. 中国胸心血管外科临床杂志， 2012， 19 （6）：624-628.
7. 　van der Sluis PC， Ruurda JP， van der Horst S， et al. Robot-assisted minimally invasive thoraco-laparoscopic esophagectomy versus open transthoracicesophagectomy for resectable esophageal cancer， a randomized controlled trial （ROBOT trial）. Trials， 2012， 13：230.
8. 　Cuesta MA， Biere SS， Henegouwen MI， et al. Randomised trial， Minimally Invasive Oesophagectomy versus open oesophagectomy for patients with resectable oesophageal cancer. J Thorac Dis， 2012， 4 （5）：462-464.
9. 　Bailey SH， Bull DA， Harpole DH， et al. Outcomes after esophagectomy：a ten-year prospective cohort. Ann Thorac Surg， 2003， 75 （1）：217-222.
10. 　Dantoc MM， Cox MR， Eslick GD. Does Minimally Invasive Esopha-gectomy （MIE） provide for comparable oncologic outcomes to open techniques ? A systematic review. J Gastrointest Surg， 2012， 16 （3）：486-494.
11. 　Gao Y， Wang Y， Chen L， et al. Comparison of open three-field and minimally-invasive esophagectomy for esophageal cancer. Interact Cardiovasc Thorac Surg， 2011， 12 （3）：366-369.
12. 　Ben-David K， Rossidis G， Zlotecki RA， et al. Minimally invasive esophagectomy is safe and effective following neoadjuvant chemoradiationtherapy. Ann Surg Oncol， 2011， 18 （12）：3324-3329.
13. 　Biere SS， Cuesta MA， van der Peet DL. Minimally invasive versusopen esophagectomy for cancer：a systematic review and meta-analysis. Minerva Chir， 2009， 64 （2）：121-133.
14. 　AtKins BZ， Shah AS， Hutcheson KA， et al. Reducing hospital morbidity and mortality following esophagectomy. Ann Thorac Surg， 2004， 78 （4）：1170-1176.
15. 　Sgourakis G， Gockel I， Radtke A， et al. Minimally invasive versus open esophagectomy：meta-analysis of outcomes. Dig Dis Sci， 2010， 55 （11）：3031-3040.

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Short-term Outcomes of Thoracoscopic and Laparoscopic-assisted Minimally Invasive McKeown Procedure for EsophagealCancer

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