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Title: Effectiveness of combined thoracoscopic-laparoscopic esophagectomy: comparison of postoperative complications and midterm oncological outcomes in patients with esophageal cancer.
Authors: Kinjo, Yousuke
Kurita, Noriaki
Nakamura, Fumiaki
Okabe, Hiroshi  KAKEN_id
Tanaka, Eiji  KAKEN_id
Kataoka, Yoshiki
Itami, Atsushi
Sakai, Yoshiharu  kyouindb  KAKEN_id
Fukuhara, Shunichi  kyouindb  KAKEN_id
Author's alias: 金城, 洋介
福原, 俊一
Keywords: Esophagectomy
Minimally invasive surgery
Esophageal cancer
Issue Date: Feb-2012
Publisher: Springer Science+Business Media, LLC
Journal title: Surgical endoscopy
Volume: 26
Issue: 2
Start page: 381
End page: 390
Abstract: [Background ] : During esophagectomy, laparoscopy can be used together with thoracoscopy, but it is not known whether a combined thoracoscopic–laparoscopic procedure is associated with fewer postoperative complications than open esophagectomy, and without compromising oncological outcome. [Methods ] : This was a longitudinal cohort study that included 185 esophageal cancer patients, including 72 who underwent combined thoracoscopic–laparoscopic esophagectomy (TLE), 34 who underwent thoracoscopic esophagectomy (TE), and 79 who underwent open esophagectomy (OE) between January 2002 and May 2010. The main outcome measures were postoperative respiratory and overall complications. The secondary outcome was 2-year relapse-free survival (RFS). [Results ] : Respiratory complications occurred in 9 patients who underwent TLE, 13 who underwent TE, and 31 who underwent OE. TLE was associated with fewer respiratory complications (TLE vs. OE: odds ratio [OR], 0.22; 95% confidence interval [CI], 0.09–0.53 and TE vs. OE: OR, 0.71; 95% CI 0.29–1.76). Overall complications occurred in 34 patients who underwent TLE, 20 who underwent TE, and 54 who underwent OE. TLE was associated with fewer overall complications (TLE vs. OE: OR, 0.47; 95% CI 0.23–0.94 and TE vs. OE: OR, 0.51; 95% CI 0.21–1.25). The 2-year RFS rates were similar among the three groups: 71.6% for TLE, 57.7% for TE, and 58.3% for OE (TLE vs. OE: hazard ratio, 0.65; 95% CI 0.35–1.20 and TE vs. OE: hazard ratio, 0.91; 95% CI 0.45–1.82). [Conclusion ] : Unlike TE, TLE was associated with fewer postoperative complications than was OE, with no compromise of 2-year RFS. A randomized controlled trial with longer follow-up is needed.
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This is not the published version. Please cite only the published version.
DOI(Published Version): 10.1007/s00464-011-1883-y
PubMed ID: 21898014
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