Thoracoscopic esophagectomy with total meso-esophageal excision reduces regional lymph node recurrence
Thoracoscopic esophagectomy with total meso-esophageal excision reduces regional lymph node recurrence
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DOI：
10.1007/s00423-018-1727-5
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发表时间：
2018-12-01
影响因子：
2.3
通讯作者：
Sasaki, Akira
中科院分区：
文献类型：
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作者：
Akiyama, Yuji;Iwaya, Takeshi;Sasaki, Akira
目的探讨俯卧位胸腔镜食管癌根治术（TE）的手术效果。方法回顾性分析140例食管癌患者行TE根治术的病历资料，并与术前治疗的患者进行比较（非食管中层;非ME组）和之后（ME组）采用全食管系膜切除术（ME）（非ME组与ME组，28.3%与41.4%，p=0.119），30天死亡率（非ME组vs. ME组，0% vs. 1.1%; p=0.433）和住院死亡率（非ME组vs. ME组，1.9% vs. 0%，p=0.199）。虽然两组的总生存期和无复发生存期无显著差异，但ME组的总复发率显著低于非ME组（非ME组vs. ME组，43.4% vs. 23%，p=0.011）。特别是，区域淋巴结复发率在纵隔是较低的ME组（非ME组与ME组，11.3%比2.3%; P=0.026）。ConclusionsOur结果表明，ME程序可能是一个程序，减少区域淋巴结复发在纵隔没有任何恶化的短期结果。
PurposeWe investigated the operative outcomes of thoracoscopic esophagectomy (TE) in the prone position, using the concept of total meso-esophageal excision for esophageal cancer.MethodsThe medical records of 140 consecutive patients with esophageal cancer who underwent radical esophagectomy by TE were reviewed retrospectively, and operative outcomes were compared between patients treated before (non-meso-esophagus; non-ME group) and after (ME group) the introduction of total meso-esophageal excision (ME).ResultsThere were no significant differences between the groups in postoperative morbidity (non-ME group vs. ME group, 28.3% vs. 41.4%, p=0.119), 30-day mortality (non-ME group vs. ME group, 0% vs. 1.1%; p=0.433), and in-hospital mortality (non-ME group vs. ME group, 1.9% vs. 0%, p=0.199). Although overall survival and relapse-free survival did not differ significantly between the groups, the overall recurrence rate was significantly lower in the ME group than the non-ME group (non-ME group vs. ME group, 43.4% vs. 23%, p=0.011). In particular, the rate of regional lymph node recurrence in the mediastinum was lower in the ME group (non-ME group vs. ME group, 11.3% vs. 2.3%; p=0.026).ConclusionsOur results suggest that the ME procedure might be one of the procedures that reduce regional lymph node recurrence in the mediastinum without any deterioration in short-term outcomes.