Short-term efficacy of purse-string Ivor-Lewis approach in minimally invasive esophagectomy for middle and lower esophageal cancer: A case control study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHOU Yang ,  LIU Jian , ZHAN Bicheng

Department of Cardiothoracic Surgery, Anqing Municipal Hospital, Affiliated Hospital of Anhui Medical University, Anqing, 246003, Anhui, P.R.China;

Corresponding?author：

LIU Jian, Email: liujianaqslyy@126.com

Keywords：

Esophageal cancer; minimally invasive esophagectomy; hand-sewn purse string; Ivor-Lewis approach

DOI：

10.7507/1007-4848.201708014

Video：

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Objective To compare the short-term efficacy of Ivor-Lewis via hand-sewn purse-string approach and purse-string forceps approach in minimally invasive esophagectomy for middle and lower esophageal cancer, and to discuss the safety and feasibility of hand-sewn purse-string anastomosis technique for minimally invasive Ivor-Lewis esophagectomy (MIILE). Methods The clinical data of 151 patients undergoing thoracoscopic and laparoscopic esophageal cancer surgery from January 2014 to January 2017 in our hospital were retrospectively analyzed. According to the different methods of purse string making, the patients were divided into a purse-string forceps group including 49 males and 16 females with a mean age of 67.98±7.07 years ranging from 51 to 80 years treated with forceps to make purse-string and a handcraft group including 61 males and 25 females with a mean age of 67.76±8.18 years ranging from 52 to 83 years using hand-sewn way. The perioperative data of two two groups were compared. Results The purse-string making time and postoperative total volume of chest drainage were less in the handcraft group than those in the purse-string forceps group (P<0.05). There was no significant difference between the two groups in hemorrhage during operation, the operation duration or postoperative hospital stay (P>0.05). There was also no statistical difference between the two groups in the rate of anastomotic or gastric tube fistula, anastomotic stenosis, pulmonary infection or incision infection (P>0.05). Conclusion In minimally invasive esophagectomy for middle-lower section, MIILE by hand-sewn purse-string is as safe as purse-string forceps, with no more complications, needing no professional equipments, and easy to learn, master and promote.

Citation： ZHOU Yang, LIU Jian, ZHAN Bicheng. Short-term efficacy of purse-string Ivor-Lewis approach in minimally invasive esophagectomy for middle and lower esophageal cancer: A case control study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(5): 416-419. doi: 10.7507/1007-4848.201708014 Copy

1.	Zheng R, Zeng H, Zhang S, et al. National estimates of cancer prevalence in China, 2011.Cancer Letters, 2016, 370(1): 33-38.
2.	范玉慧, 郭石平, 杜小祥. 食管癌微創外科治療的現狀與進展. 中華臨床醫師雜志 (電子版), 2015, 9(6): 1022-1026.
3.	Khan M, Muzaffar A, Syed AA, et al. Changes in oncological outcomes: comparison of the conventional and minimally invasive esophagectomy, a single institution experience. Updates Surg, 2016, 68(4): 343-349.
4.	梅閃閃, 劉繼先, 吳昊, 等.微創荷包鉗法 Ivor-Lewis 術與 McKeown 術治療中下段食管癌的近期療效分析.重慶醫科大學學報, 2016, (1): 89-93.
5.	Xie MR, Liu CQ, Guo MF, et al. Short-term outcomes of minimally invasive Ivor-Lewis esophagectomy for esophageal cancer. Ann Thorac Surg, 2014, 97(5): 1721-1727.
6.	Zhang RQ, Xia WL, Kang NN, et al. Pursestring stapled anastomotic technique for minimally invasive Ivor Lewis esophagectomy. Ann Thorac Surg, 2012, 94(6): 2133-2135.
7.	李俊彥, 王勇, 劉偉良, 等.管狀胃食管頸部分層吻合與機械吻合在食管癌手術中的應用比較.中國胸心血管外科臨床雜志, 2017, 24(1): 61-64.
8.	詹必成, 劉建, 陳劍, 等. 胸腹腔鏡 Ivor-Lewis 食管癌根治術 60 例. 安徽醫學, 2014, 35(12): 1641-1643.
9.	Wu W, Zhu Q, Chen L, et al. Technical and early outcomes of Ivor Lewis minimally invasive oesophagectomy for gastric tube construction in the thoracic cavity. Interact Cardiovasc Thorac Surg, 2014, 18(1): 86-91.
10.	柳常青, 解明然, 郭明發, 等. 微創 Ivor-Lewis 食管癌根治術圍手術期結果分析. 中華腫瘤防治雜志, 2014, 21(6): 454-457.
11.	高云飛, 吳振華, 孫偉. 食管癌術后兩種胸腔閉式引流量下不同拔管時機的臨床效果比較. 中國醫學創新, 2015, 12(33): 79-81.
12.	田燁, 周凌霄, 任光國. 1208 例食管癌患者術后吻合口瘺風險因素分析. 重慶醫學, 2014, 43(15): 1924-1927.
13.	Zhu C, Jin K. Minimally invasive esophagectomy for esophageal cancer in the People's Republic of China: an overview. Onco Targets Ther, 2013, 6: 119-124.
14.	Williams VA, Watson TJ, Zhovtis S, et al. Endoscopic and symptomatic assessment of anastomotic strictures following esophagectomy and cervical esophagogastrostomy. Surg Endosc, 2008, 22(6): 1470-1476.
15.	Chittick P, Russo V, Sims M, et al. An outbreak of pseudomonas aeruginosa respiratory tract infections associated with intrinsically contaminated ultrasound transmission gel. Infect Control Hosp Epidemiol, 2013, 34(8): 850-853.
16.	Baker CR, Bailey ME, Soon Y, et al. Two-phase laparoscopic-assisted oesophago-gastrectomy: a single-unit experience of 111 consecutive cases and outcomes. Surg Endosc, 2011, 25(11): 3658-3667.
17.	謝錫浩, 林萬里, 陳穎, 等. 腔鏡食管癌根治術對食管癌患者并發癥的影響. 新醫學, 2015, 46(9): 625-628.

1. Zheng R, Zeng H, Zhang S, et al. National estimates of cancer prevalence in China, 2011.Cancer Letters, 2016, 370(1): 33-38.
2. 范玉慧, 郭石平, 杜小祥. 食管癌微創外科治療的現狀與進展. 中華臨床醫師雜志 (電子版), 2015, 9(6): 1022-1026.
3. Khan M, Muzaffar A, Syed AA, et al. Changes in oncological outcomes: comparison of the conventional and minimally invasive esophagectomy, a single institution experience. Updates Surg, 2016, 68(4): 343-349.
4. 梅閃閃, 劉繼先, 吳昊, 等.微創荷包鉗法 Ivor-Lewis 術與 McKeown 術治療中下段食管癌的近期療效分析.重慶醫科大學學報, 2016, (1): 89-93.
5. Xie MR, Liu CQ, Guo MF, et al. Short-term outcomes of minimally invasive Ivor-Lewis esophagectomy for esophageal cancer. Ann Thorac Surg, 2014, 97(5): 1721-1727.
6. Zhang RQ, Xia WL, Kang NN, et al. Pursestring stapled anastomotic technique for minimally invasive Ivor Lewis esophagectomy. Ann Thorac Surg, 2012, 94(6): 2133-2135.
7. 李俊彥, 王勇, 劉偉良, 等.管狀胃食管頸部分層吻合與機械吻合在食管癌手術中的應用比較.中國胸心血管外科臨床雜志, 2017, 24(1): 61-64.
8. 詹必成, 劉建, 陳劍, 等. 胸腹腔鏡 Ivor-Lewis 食管癌根治術 60 例. 安徽醫學, 2014, 35(12): 1641-1643.
9. Wu W, Zhu Q, Chen L, et al. Technical and early outcomes of Ivor Lewis minimally invasive oesophagectomy for gastric tube construction in the thoracic cavity. Interact Cardiovasc Thorac Surg, 2014, 18(1): 86-91.
10. 柳常青, 解明然, 郭明發, 等. 微創 Ivor-Lewis 食管癌根治術圍手術期結果分析. 中華腫瘤防治雜志, 2014, 21(6): 454-457.
11. 高云飛, 吳振華, 孫偉. 食管癌術后兩種胸腔閉式引流量下不同拔管時機的臨床效果比較. 中國醫學創新, 2015, 12(33): 79-81.
12. 田燁, 周凌霄, 任光國. 1208 例食管癌患者術后吻合口瘺風險因素分析. 重慶醫學, 2014, 43(15): 1924-1927.
13. Zhu C, Jin K. Minimally invasive esophagectomy for esophageal cancer in the People's Republic of China: an overview. Onco Targets Ther, 2013, 6: 119-124.
14. Williams VA, Watson TJ, Zhovtis S, et al. Endoscopic and symptomatic assessment of anastomotic strictures following esophagectomy and cervical esophagogastrostomy. Surg Endosc, 2008, 22(6): 1470-1476.
15. Chittick P, Russo V, Sims M, et al. An outbreak of pseudomonas aeruginosa respiratory tract infections associated with intrinsically contaminated ultrasound transmission gel. Infect Control Hosp Epidemiol, 2013, 34(8): 850-853.
16. Baker CR, Bailey ME, Soon Y, et al. Two-phase laparoscopic-assisted oesophago-gastrectomy: a single-unit experience of 111 consecutive cases and outcomes. Surg Endosc, 2011, 25(11): 3658-3667.
17. 謝錫浩, 林萬里, 陳穎, 等. 腔鏡食管癌根治術對食管癌患者并發癥的影響. 新醫學, 2015, 46(9): 625-628.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Short-term efficacy of purse-string Ivor-Lewis approach in minimally invasive esophagectomy for middle and lower esophageal cancer: A case control study

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