Esophagectomies for Esophageal Cancer: Video-Assisted Thoracoscopic Surgery (VATS) Versus a Traditional Thoracotomy

Background and Purpose:An esophagectomy has traditionally been performed via a thoracotomy. In recent years, increasing numbers of surgeons are using a minimally invasiveesophagectomy for esophageal cancers. During the past 3 years, we treated 49 esophageal cancers by a thoracotomy or video-assisted thoracoscopic surgery (VATS). We retrospectively reviewed the medical records for data analysis and outcome assessment of these 2 groups. Materials andMethods:In total, 49 patients with esophageal squamous cell carcinomas were enrolled in thestudy. All operations were carried out under general anesthesia. All of the thoracotomy groupunderwent a right-side standard posterolateral thoracotomy. All of the VATS group received4 ports in the right-side chest. Thoracic procedures were performed by a thoracic surgeon.All abdominal procedures used an upper midline laparotomy by a general surgeon. Medicalrecords were retrospectively reviewed for data collection and analysis. Results:There were 33thoracotomies and 16 VATSs. There were no differences in operative time, blood loss, or numbers of removed lymph nodes between the 2 groups. The VATS group had less-advanced T stage (more T2 and fewer T3 cases) than the thoracotomy group. There were signifi cant differences in lengthsof ventilator use, intensive care unit stay, hospital stay and postoperative pain. Conclusions:A VATS esophagectomy was as effective as a thoracotomic esophagectomy in treating resectable esophageal cancers. Signifi cant advantages of VATS were observed in shortening the length of ventilator use, ICU stay, hospital stay, and postoperative pain. (FJJM 2011; 9 (1): 23-29)