초록접수 현황
| 14F-051 | 포럼 발표 |
Perioperative Results of Less Invasive Esophagectomy for Esophageal Squamous Cell Carcinoma Comparing with Open Surgery: Results of Single Center, Single Surgeon.
Eunjue Yi, MD.1, Dong-Jin Kim, BSN.1 , Sukki Cho, MD., PhD.1,2, Kwhanmien Kim, MD., Ph.D.1,2, Sanghoon Jheon, M.D., Ph.D.1,2
1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Gyeonggi, Korea.
2. Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Korea.
Background : We evaluated the safety and feasibility of less invasive technique in esophagectomy for esophageal squamous cell carcinoma in a single center, performed by a single surgeon.
Methods : The medical records of esophageal squamous cell cancer patients who underwent curative resections and reconstruction with stomach by a single surgeon during 2003 and 2013 in a single institute were reviewed retrospectively. Patients were categorized into two groups. One was open group, whose surgeries performed with totally open procedures. The other was less invasive group, with at least one kind of endoscopic procedures such as laparoscopic gastric mobilization or VATS esophagectomy. Perioperative results and complications were compared.
Results : Total 111 patients were enrolled. Open group were 57 and less invasive group were 54. No statistical differences were observed in stages, tumor location, anastomotic techniques or rates of perioperative complications between two groups. In open group, 38.6% patients received neoadjuvant chemotherapy, while only 5.6% in endoscopic group. (p<0.000) Perioperative results including operation time, hospital stay, duration of chest tube and nasogastric tube, number of total dissected lymph nodes and distance of safety margin showed no statistical significance between two groups. Total complication rates were 21.6%. Those of open group were 22.8%, and less invasive group were 20.4%. No significant differences observed between two groups in complication rates, (p=0.820) though anastomotic leak had appeared only in open group. No intraoperative mortality reported during follow-up periods. Overall survival periods were 38.4±28.42 months. Those of open group were 31.0±23.63 and those of endoscopic group were 46.2±31.05. Statistically significant differences observed between two groups in overall survival. (P=0.005)
Conclusion : Less invasive procedures in esophageal cancer surgery could be safe and feasible with comparable perioperative results, complication rates and oncological efficacy.
Methods : The medical records of esophageal squamous cell cancer patients who underwent curative resections and reconstruction with stomach by a single surgeon during 2003 and 2013 in a single institute were reviewed retrospectively. Patients were categorized into two groups. One was open group, whose surgeries performed with totally open procedures. The other was less invasive group, with at least one kind of endoscopic procedures such as laparoscopic gastric mobilization or VATS esophagectomy. Perioperative results and complications were compared.
Results : Total 111 patients were enrolled. Open group were 57 and less invasive group were 54. No statistical differences were observed in stages, tumor location, anastomotic techniques or rates of perioperative complications between two groups. In open group, 38.6% patients received neoadjuvant chemotherapy, while only 5.6% in endoscopic group. (p<0.000) Perioperative results including operation time, hospital stay, duration of chest tube and nasogastric tube, number of total dissected lymph nodes and distance of safety margin showed no statistical significance between two groups. Total complication rates were 21.6%. Those of open group were 22.8%, and less invasive group were 20.4%. No significant differences observed between two groups in complication rates, (p=0.820) though anastomotic leak had appeared only in open group. No intraoperative mortality reported during follow-up periods. Overall survival periods were 38.4±28.42 months. Those of open group were 31.0±23.63 and those of endoscopic group were 46.2±31.05. Statistically significant differences observed between two groups in overall survival. (P=0.005)
Conclusion : Less invasive procedures in esophageal cancer surgery could be safe and feasible with comparable perioperative results, complication rates and oncological efficacy.
책임저자: 전상훈
분당서울대학교병원 흉부외과학교실
연락처 : 이은주, Tel: 031-787-7146 , E-mail : viking99@hanmail.net
