Objective To compare the clinical effect of minimally invasive esophagectomy(MIE) versus open esophagectomy (OE) on elderly esophageal carcinoma patients(≥70 years old), to provide the relevant theoretical basis for the clinical application of minimally invasive surgery on esophageal carcinoma.
Methods We retrospectively reviewed the data of the randomly-selected elderly patients who underwent MIE or OE(each 52) in the Department of Thoracic Surgery.
Results The MIE group was successfully performed under thoracoscopy and laparoscopy without conversion to open esophagectomy. The mean operation time were (261.4±35.2) and (249.0±37.0)min in MIE and OE groups (P > 0.05). The intraoperative blood loss on average were respectively about (190.1±86.8) and (391.35±118.5)ml in MIE and OE groups(P < 0.05). The white blood cell(WBC), C-reactive protein(CRP) and postoperative pain evaluation were better in the MIE group than those in the OE group (P < 0.05). There was no significant difference in anastomotic fistula, recurrent laryngeal nerve injury or chylothorax between the two groups, but the incidence of pulmonary infection, respiratory failure and arrhythmia in MIE group was lower than those in OE group (P < 0.05). The hospitalization time in MIE group was less than that in OE group (P < 0.05). The patients were followed up for (22.1±11.1) months, there was no significant difference in survival time between the two groups (P=0.985).
Conclusion Clinical application of MIE could significantly reduce the elderly patients' postoperative pain, systemic inflammatory response, the incidence of complications such as cardiopulmonary system, as well as the length of hospital stay. It is conducive to rapid recovery of elderly esophageal cancer patients.
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