Low invasiveness of thoracoscopic esophagectomy in the prone position for esophageal cancer: a propensity score-matched comparison of operative approaches between thoracoscopic and open esophagectomy
In this study, cytokine levels, outcome, and survival rates after esophagectomy for esophageal cancer were retrospectively investigated in a propensity score-matched comparison of operative approaches between the thoracoscopic esophagectomy (TE) in the prone position and open esophagectomy (OE).
Patients and Methods
Between 2005 and 2014, TE was performed on a group of 85 patients, which was compared with a group of 104 OE cases. Eventually, 65 paired cases were matched using propensity score matching.
Although the TE group underwent a significantly longer operation time than the OE group (P < 0.001), the TE group exhibited less blood loss (P < 0.001) and had a shorter postoperative hospital stay (P = 0.038) than the OE group. The serum interleukin-6 levels on ICU admission (P < 0.001) and on POD 1 (P < 0.001) were significantly lower in the TE group. The interleukin-10 levels on ICU admission (P < 0.001), POD 1 (P = 0.016), and POD 3 (P < 0.001) were also significantly lower in the TE group. Pulmonary complication was significantly lower in the TE group (P = 0.043). The 5-year PFS rates in the TE and OE groups were 70.6 and 58.7% (P = 0.328), respectively, and OS rates were 64.9 and 50.2% (P = 0.101), respectively.
TE compared to OE is a less invasive procedure with lower surgical stress and less pulmonary complication for the treatment of esophageal squamous cell carcinoma.
KeywordsEsophageal cancer Minimally invasive surgery Cytokines Surgical stress Prone position
The study was supported by JSPS KAKENHI Grant Number 24791379.
Compliance with ethical standards
Shoichi Hazama received research funding from NEC Corporation and Toyo Kohan Corporation. All authors had full access to all of the data in the study and had final responsibility for the decision to submit for publication. Drs. Kanekiyo, Drs. Takeda, Drs. Tsutsui, Drs. Nishiyama, Drs. Kitahara, Drs. Shindo, Drs. Tokumitsu, Drs. Tomochika, Drs. Tokuhisa, Drs. Iida, Drs. Sakamoto, Drs. Suzuki, Drs. Yamamoto, Drs. Yoshino, Drs. Ueno, Drs. Nagano have no conflicts of interest or financial ties to disclose.
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