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Date Published:
28/10/2024
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Nguyễn, V. T., Lê, T. S., & Nguyễn, A. T. (2024). ĐÁNH GIÁ KẾT QUẢ SỚM PHẪU THUẬT NỘI SOI NGỰC CẮT THỰC QUẢN VÉT HẠCH 2 VÙNG ĐIỀU TRỊ UNG THƯ THỰC QUẢN NGỰC 1/3 GIỮA VÀ 1/3 DƯỚI. Journal of Military Pharmaco-medicine, 49(8), 152-162. https://doi.org/10.56535/jmpm.v49i8.908
ĐÁNH GIÁ KẾT QUẢ SỚM PHẪU THUẬT NỘI SOI NGỰC CẮT THỰC QUẢN VÉT HẠCH 2 VÙNG ĐIỀU TRỊ UNG THƯ THỰC QUẢN NGỰC 1/3 GIỮA VÀ 1/3 DƯỚI
Main Article Content
Abstract
Objective: Evaluate early results of thoracoscopic esophagectomy and 2-field lymph node dissection for esophageal cancer in the middle and lower 1/3 of the thoracic.
Research objects and methods: cross-sectional, prospective, descriptive study. 70 patients with esophageal cancer in the middle 1/3 and lower 1/3 of the thoracic underwent thoracoscopic esophagectomy and 2-field lymph node dissection at Central Hospital 108 and Hospital 103 from June 2022 to June 2024.
Results: Mean age 59.0 ± 7.9 years old, male: 100%, preoperative chemotherapy and radiotherapy: (77.1%). Tumor location: middle 1/3: 61.4%, lower 1/3: 38.6%. The average surgery time is 254.3 ± 34.9 minutes, the amount of blood loss is 80 (50 – 100) ml. The abdomenal step was treated with laparoscopic surgery and assisted laparoscopic surgery accounting for 90%. Complications: 5 patients (7.1%), 1.4% had lung parenchymal injury, 4.3% had thoracic duct injury, 1.4% of Azygos vein injury. The average number of lymph nodes removed was 25.0 (20.8 – 34), the lymph node metastasis rate was 3.7%. General complications account for 35.7%, mortality was 2.9%, respiratory complications was 17.1%, anastomotic leakage was 7.1%, chylothorax was 2.9%, and recurrent nerve damage was 14.3%. Postoperative hospital stay was 11.0 (9-14) days.
Conclusion: Thoracoscopic esophagectomy and 2-field lymph node dissection for esophageal cancer in the middle and lower 1/3 of the thoracic is safe and feasible, early post-operative recovery, and low complication rate.
Article Details
Keywords
esophageal cancer, thoracoscopic esophagectomy, esophagectomy
References
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3. Van Kooten RT, et al. Patient-related prognostic factors for anastomotic leakage, major complications, and short-term mortality following esophagectomy for cancer: A systematic review and meta-analyses. Ann Surg Oncol. 2022; 29(2)1358-1373.
4. Fan N, et al. Comparison of short- and long-term outcomes between 3-field and modern 2-field lymph node dissections for thoracic oesophageal squamous cell carcinoma: A propensity score matching analysis. Interactive CardioVascular and Thoracic Surgery. 2019; 29(3):434-441.
5. Isono K, H Sato, and K Nakayama. Results of a nationwide study on the three-field lymph node dissection of esophageal cancer. Oncology. 1991; 48(5):411-20.
6. Ma GW, et al. Three-field vs two-field lymph node dissection for esophageal cancer: A meta-analysis. World J Gastroenterol. 2014; 20(47): 18022-30.
7. Hulscher JB, et al. Injury to the major airways during subtotal esophagectomy: Incidence, management, and sequelae. J Thorac Cardiovasc Surg. 2000; 120(6):1093-1096.
8. Chen J, et al. Cervical lymph node metastasis is classified as regional nodal staging in thoracic esophageal squamous cell carcinoma after radical esophagectomy and three-field lymph node dissection. BMC Surg. 2014; 14:110.
9. Zingg U, BM, and DC. Factors associated with postoperative pulmonary morbidity after esophagectomy for cancer. Ann Surg Oncol. 2010; 18: 1460-1468.
10. Varshney VK, et al. Management options for post-esophagectomy chylothorax. Surg Today. 2021; 51(5): 678-685.
2. Fujita H, et al. Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer. Comparison of three-field lymphadenectomy with two-field lymphadenectomy. Ann Surg. 1995; 222(5):654-62.
3. Van Kooten RT, et al. Patient-related prognostic factors for anastomotic leakage, major complications, and short-term mortality following esophagectomy for cancer: A systematic review and meta-analyses. Ann Surg Oncol. 2022; 29(2)1358-1373.
4. Fan N, et al. Comparison of short- and long-term outcomes between 3-field and modern 2-field lymph node dissections for thoracic oesophageal squamous cell carcinoma: A propensity score matching analysis. Interactive CardioVascular and Thoracic Surgery. 2019; 29(3):434-441.
5. Isono K, H Sato, and K Nakayama. Results of a nationwide study on the three-field lymph node dissection of esophageal cancer. Oncology. 1991; 48(5):411-20.
6. Ma GW, et al. Three-field vs two-field lymph node dissection for esophageal cancer: A meta-analysis. World J Gastroenterol. 2014; 20(47): 18022-30.
7. Hulscher JB, et al. Injury to the major airways during subtotal esophagectomy: Incidence, management, and sequelae. J Thorac Cardiovasc Surg. 2000; 120(6):1093-1096.
8. Chen J, et al. Cervical lymph node metastasis is classified as regional nodal staging in thoracic esophageal squamous cell carcinoma after radical esophagectomy and three-field lymph node dissection. BMC Surg. 2014; 14:110.
9. Zingg U, BM, and DC. Factors associated with postoperative pulmonary morbidity after esophagectomy for cancer. Ann Surg Oncol. 2010; 18: 1460-1468.
10. Varshney VK, et al. Management options for post-esophagectomy chylothorax. Surg Today. 2021; 51(5): 678-685.