Esophagectomies for Esophageal Cancer: Video-Assisted Thoracoscopic Surgery (VATS) Versus a Traditional Thoracotomy

Ming Hong Yen, Shih-Han Hung, Ching Shui Huang, Jung Sen Liu

Research output: Contribution to journalArticle

Abstract

Background and Purpose:An esophagectomy has traditionally been performed via a thoracotomy. In recent years, increasing numbers of surgeons are using a minimally invasiveesophagectomy for esophageal cancers. During the past 3 years, we treated 49 esophageal cancers by a thoracotomy or video-assisted thoracoscopic surgery (VATS). We retrospectively reviewed the medical records for data analysis and outcome assessment of these 2 groups. Materials andMethods:In total, 49 patients with esophageal squamous cell carcinomas were enrolled in thestudy. All operations were carried out under general anesthesia. All of the thoracotomy groupunderwent a right-side standard posterolateral thoracotomy. All of the VATS group received4 ports in the right-side chest. Thoracic procedures were performed by a thoracic surgeon.All abdominal procedures used an upper midline laparotomy by a general surgeon. Medicalrecords were retrospectively reviewed for data collection and analysis. Results:There were 33thoracotomies and 16 VATSs. There were no differences in operative time, blood loss, or numbers of removed lymph nodes between the 2 groups. The VATS group had less-advanced T stage (more T2 and fewer T3 cases) than the thoracotomy group. There were signifi cant differences in lengthsof ventilator use, intensive care unit stay, hospital stay and postoperative pain. Conclusions:A VATS esophagectomy was as effective as a thoracotomic esophagectomy in treating resectable esophageal cancers. Signifi cant advantages of VATS were observed in shortening the length of ventilator use, ICU stay, hospital stay, and postoperative pain. (FJJM 2011; 9 (1): 23-29)
Original languageEnglish
Pages (from-to)23-29
Number of pages7
Journal輔仁醫學期刊
Volume9
Issue number1
Publication statusPublished - 2011
Externally publishedYes

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Video-Assisted Thoracic Surgery
Esophagectomy
Thoracotomy
Esophageal Neoplasms
Thorax
Mechanical Ventilators
Postoperative Pain
Length of Stay
Operative Time
Laparotomy
General Anesthesia
Medical Records
Intensive Care Units
Lymph Nodes
Outcome Assessment (Health Care)
Surgeons

Keywords

  • 影像輔助胸腔鏡手術
  • 開胸手術
  • 食道癌
  • VATS
  • thoracotomy
  • esophageal cancer

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Esophagectomies for Esophageal Cancer: Video-Assisted Thoracoscopic Surgery (VATS) Versus a Traditional Thoracotomy. / Yen, Ming Hong; Hung, Shih-Han; Huang, Ching Shui; Liu, Jung Sen.

In: 輔仁醫學期刊, Vol. 9, No. 1, 2011, p. 23-29.

Research output: Contribution to journalArticle

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N2 - Background and Purpose:An esophagectomy has traditionally been performed via a thoracotomy. In recent years, increasing numbers of surgeons are using a minimally invasiveesophagectomy for esophageal cancers. During the past 3 years, we treated 49 esophageal cancers by a thoracotomy or video-assisted thoracoscopic surgery (VATS). We retrospectively reviewed the medical records for data analysis and outcome assessment of these 2 groups. Materials andMethods:In total, 49 patients with esophageal squamous cell carcinomas were enrolled in thestudy. All operations were carried out under general anesthesia. All of the thoracotomy groupunderwent a right-side standard posterolateral thoracotomy. All of the VATS group received4 ports in the right-side chest. Thoracic procedures were performed by a thoracic surgeon.All abdominal procedures used an upper midline laparotomy by a general surgeon. Medicalrecords were retrospectively reviewed for data collection and analysis. Results:There were 33thoracotomies and 16 VATSs. There were no differences in operative time, blood loss, or numbers of removed lymph nodes between the 2 groups. The VATS group had less-advanced T stage (more T2 and fewer T3 cases) than the thoracotomy group. There were signifi cant differences in lengthsof ventilator use, intensive care unit stay, hospital stay and postoperative pain. Conclusions:A VATS esophagectomy was as effective as a thoracotomic esophagectomy in treating resectable esophageal cancers. Signifi cant advantages of VATS were observed in shortening the length of ventilator use, ICU stay, hospital stay, and postoperative pain. (FJJM 2011; 9 (1): 23-29)

AB - Background and Purpose:An esophagectomy has traditionally been performed via a thoracotomy. In recent years, increasing numbers of surgeons are using a minimally invasiveesophagectomy for esophageal cancers. During the past 3 years, we treated 49 esophageal cancers by a thoracotomy or video-assisted thoracoscopic surgery (VATS). We retrospectively reviewed the medical records for data analysis and outcome assessment of these 2 groups. Materials andMethods:In total, 49 patients with esophageal squamous cell carcinomas were enrolled in thestudy. All operations were carried out under general anesthesia. All of the thoracotomy groupunderwent a right-side standard posterolateral thoracotomy. All of the VATS group received4 ports in the right-side chest. Thoracic procedures were performed by a thoracic surgeon.All abdominal procedures used an upper midline laparotomy by a general surgeon. Medicalrecords were retrospectively reviewed for data collection and analysis. Results:There were 33thoracotomies and 16 VATSs. There were no differences in operative time, blood loss, or numbers of removed lymph nodes between the 2 groups. The VATS group had less-advanced T stage (more T2 and fewer T3 cases) than the thoracotomy group. There were signifi cant differences in lengthsof ventilator use, intensive care unit stay, hospital stay and postoperative pain. Conclusions:A VATS esophagectomy was as effective as a thoracotomic esophagectomy in treating resectable esophageal cancers. Signifi cant advantages of VATS were observed in shortening the length of ventilator use, ICU stay, hospital stay, and postoperative pain. (FJJM 2011; 9 (1): 23-29)

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