Effect of totally laparoscopic Ivor Lewis esophagectomy without thoracoscopic small incision on middle and lower thoracic esophageal cancer

Abstract

Objective To analyze the effect of total endoscopic resection of esophageal carcinoma with Ivor Lewis without abdominal small incision on patients with middle and lower thoracic esophageal carcinoma . Methods Forty-five patients with middle and lower thoracic esophageal cancer admitted to Yuncheng Central Hospital from May 2013 to July 2016 were selected as the observation group, who were treated by total endoscopic resection of esophageal cancer without abdominal incision. Forty-four patients who underwent minimally invasive Mc Keown operation were selected as the control group. The operation conditions (blood loss, operation time, number of lymph node dissection), VAS scores at different time points (12 h, 24 h after operation) and serum tumor malignant biological behavior indexes[serum vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9), CD44v] were observed and compared between the two groups, the complications and recurrence rates of the two groups were also analyzed. Results There was no significant difference in the intraoperative blood loss or number of lymph hode dissection between the two groups (P>0.05). The operative time of the observation group was lower than that of the control group (P<0.05). The VAS scores at 24 h after operation, serum levels of VEGF, MMP-9 and CD44v were lower in the observation group than those in the control group (P<0.05). The incidence of complications in the observation group was 8.89%(9/45), which was lower than those in the control group [25.00%(11/44)], there was significant difference(P<0.05). The recurrence rate of the observation group was 11.11%(5/45), which was lower than that of the control group [34.09%(15/44)]. The difference was different, P<0.05. Conclusions No small abdominal incision and total endoscopic Ivor Lewis resection of esophageal carcinoma in patients with middle and lower thoracic esophageal carcinoma can shorten the operation time, reduce the incidence of complications, relieve the pain and prevent the malignant biological behavior of tumor, and reduce the recurrence rate. And the number of lymph nodes cleared during operation, so it is worthy of clinical application. Key words: Ivor Lewis resection of esophageal carcinoma; Esophageal cancer; Middle and lower thoracic; No small abdominal incision; Total endoscope