Is minimally invasive esophagectomy beneficial to elderly patients with esophageal cancer?
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- 作者：Jingpei Li ; Yaxing Shen ; Lijie Tan ; Mingxiang Feng ; Hao Wang ; Yong Xi…
- 关键词：Esophagectomy ; Minimally invasive surgery ; Esophageal cancer ; Elderly patients ; Survival
- 刊名：Surgical Endoscopy
- 出版年：2015
- 出版时间：April 2015
- 年：2015
- 卷：29
- 期：4
- 页码：925-930
- 全文大小：315 KB
- 参考文献：1. Luketich, JD, Pennathur, A, Awais, O, Levy, RM, Keeley, S, Shende, M (2012) Outcomes after minimally invasive esophagectomy: review of over 1000 patients. Ann Surg 256: pp. 95-103 CrossRef
2. Moskovitz, AH, Rizk, NP, Venkatraman, E, Bains, MS, Flores, RM, Park, BJ (2006) Mortality increases for octogenarians undergoing esophagogastrectomy for esophageal cancer. Ann Thorac Surg 82: pp. 2031-2036 CrossRef
3. Morita, M, Otsu, H, Kawano, H, Kumashiro, R, Taketani, K, Kimura, Y (2013) Advances in esophageal surgery in elderly patients with thoracic esophageal cancer. Anticancer Res 33: pp. 1641-1647
4. Kinugasa, S, Tachibana, M, Yoshimura, H, Dhar, DK, Shibakita, M, Ohno, S (2001) Esophageal resection in elderly esophageal carcinoma patients: improvement in postoperative complications. Ann Thorac Surg 71: pp. 414-418 CrossRef
5. Biere, SS, Berge, HM, Maas, KW, Bonavina, L, Rosman, C, Garcia, JR (2012) Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet 379: pp. 1887-1892 CrossRef
6. Wang, H, Feng, M, Tan, L, Wang, Q (2010) Comparison of the short-term quality of life in patients with esophageal cancer after subtotal esophagectomy via video-assisted thoracoscopic or open surgery. Dis Esophagus 23: pp. 408-414 CrossRef
7. Smithers, BM, Gotley, DC, Martin, I, Thomas, JM (2007) Comparison of the outcomes between open and minimally invasive esophagectomy. Ann Surg 245: pp. 232-240 CrossRef
8. Nagpal, K, Ahmed, K, Vats, A, Yakoub, D, James, D, Ashrafian, H (2010) Is minimally invasive surgery beneficial in the management of esophageal cancer? a meta-analysis. Surg Endosc 24: pp. 1621-1629 CrossRef
9. Shen, Y, Feng, M, Khan, MA, Wang, H, Tan, L, Wang, Q (2014) A simple method minimizes chylothorax after minimally invasive esophagectomy. J Am Coll Surg 218: pp. 108-112 CrossRef
10. Shen, Y, Zhang, Y, Tan, L, Feng, M, Wang, H, Khan, MA (2012) Extensive mediastinal lymphadenectomy during minimally invasive esophagectomy: optimal results from a single center. J Gastrointest Surg 16: pp. 715-721 CrossRef
11. Feng, M, Shen, Y, Wang, H, Tan, L, Zhang, Y, Khan, MA (2012) Thoracolaparoscopic esophagectomy: is the prone position a safe alternative to the decubitus position?. J Am Coll Surg 214: pp. 838-844 CrossRef
12. Jougon, JB, Ballester, M, Duffy, J, Dubrez, J, Delaisement, C, Velly, JF (1997) Esophagectomy for cancer in the patient aged 70?years and older. Ann Thorac Surg 63: pp. 1423-1427 CrossRef
13. Fang, W, Igaki, H, Tachimori, Y, Sato, H, Daiko, H, Kato, H (2001) Three-field lymph node dissection for esophageal cancer in elderly patients over 70?years of age. Ann Thorac Surg 72: pp. 867-871 CrossRef
14. Pultrum, BB, Bosch, DJ, Nijsten, MW, Rodgers, MG, Groen, H, Slaets, JP (2010) Extended esophagectomy in elderly patients with esophageal cancer: minor effect of age alone in determining the postoperative course and survival. Ann Surg Oncol 17: pp. 1572-1580 CrossRef
15. Yang, HX, Ling, L, Zhang, X, Lin, P, Rong, TH, Fu, JH (2010) Outcome of elderly patients with oesophageal squamous cell carcinoma after surgery. Br J Surg 97: pp. 862-867 lic Health
Surgery
Gynecology
Gastroenterology
Hepatology
Proctology
Abdominal Surgery - 出版者：Springer New York
- ISSN：1432-2218
文摘
Background Open esophagectomy (OE) in elderly patients with esophageal cancer is hazardous due to high surgical mortality and limited survival. The aim of this study was to explore whether minimally invasive esophagectomy (MIE) has perioperative or long-term benefits in elderly patients with esophageal cancer compared with OE. Methods Between February 2005 and June 2013, 407 patients older than 70?years underwent esophagectomy for esophageal cancer, including 89 who received MIE and 318 who received OE. A retrospective pair-matched study was performed to compare 116 patients (58 pairs) who underwent either OE or MIE. Patients were matched by age, sex, comorbidity, tumor location, histology, TNM stage, and operative approach. Perioperative and long-term outcomes were compared between the two groups. Results The overall incidence of postoperative complications was significantly lower in the MIE group than in the OE group (37.9 vs. 60.3?%, P?=?0.016), especially incidence of pulmonary complications (20.7 vs. 39.7?%, P?=?0.026). The mean length of hospital stay was also significantly shorter (10?days [range 7-0] vs. 12?days [range 8-06], P?=?0.032). The perioperative mortality rate trended lower in the MIE group but was not significantly different (3.4 vs. 8.6?%, P?=?0.435). Kaplan–Meier analysis showed that the median disease-specific survival time in the MIE group was significantly longer than in the OE group (>27?months [range 1-2] vs. 24?months [range 1-9], P?=?0.003). No difference was found in overall survival (39?±?8.9 vs. 22?±?3.4?months, P?=?0.070). Conclusion In surgical management of elderly patients with esophageal cancer, MIE is associated with lower rates of morbidity and pulmonary complications as well as longer disease-specific survival time. Whether it provides benefit to patients-long-term survival requires further research.