Abstract
PurposeMinimally invasive oesophagectomy is a technically demanding procedure, and the learning curve for this procedure should be explored. A survival analysis should also be performed.MethodsA total of 214 consecutive patients who underwent minimally invasive oesophagectomy were retrospectively reviewed. To evaluate the development of thoracoscopic-laparoscopic oesophagectomy and compare mature minimally invasive oesophagectomy and open oesophagectomy, we comprehensively studied the clinical and surgical parameters. The cumulative sum (CUSUM) plot was used to evaluate the learning curve for systemic lymphadenectomy. Cox proportional hazards regression analysis was performed to explore the clinical factors affecting survival.ResultsThe bleeding volume, operation time, and postoperative mortality within 3 months significantly decreased after 20 patients. The rise point for node dissection was visually determined to occur at patient 57 in the CUSUM plots. Patients who underwent mature thoracoscopic-laparoscopic oesophagectomy had better surgical data and short-term benefits than patients who underwent an open procedure. Cox proportional hazards regression analysis showed that the maximum diameter of the tumour cross-sectional area and the number of positive nodes significantly influenced survival.ConclusionsThe results suggest that thoracoscopic-laparoscopic oesophagectomy has short-term benefits. There was no evidence that it was associated with a significantly better prognosis for patients with oesophageal cancer.ClinicalTrials Gov ID: NCT04217239; January 2, 2020 retrospectively registered.
Highlights
The incidence of oesophageal carcinoma has increased significantly over the past 20 years, and it is currently the 6th leading cause of cancer death [1, 2]
A total of 170 patients underwent oesophagectomy via open thoracotomy from August 2014 to August 2016, and these patients were defined as the open group
All patients were preoperatively diagnosed with oesophageal cancer by endoscopy and biopsy, and routine thoracic and abdominal enhanced computed tomography (CT) scans and endoscopic ultrasonography were used to evaluate the clinical TNM stage
Summary
The incidence of oesophageal carcinoma has increased significantly over the past 20 years, and it is currently the 6th leading cause of cancer death [1, 2]. Learning curves and other parameters for lymph node dissection were reported over the past few years [11,12,13,14], systematic analyses of these learning curves, the clinical indexes. From July 2010 to August 2016, 214 patients underwent MIE for oesophageal cancer and were followed up. The clinical parameters were analysed to examine the learning curve and characteristics of MIE. A clinical comparative study of mature MIE versus open oesophagectomy (OE) for oesophageal carcinoma was performed, and a Cox proportional hazards regression analysis was used to determine the clinical risk factors for overall survival
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