Comparison of three-field esophagectomy for esophageal cancer incorporating open or thoracoscopic thoracotomy.
BACKGROUND
Thoracoscopic esophagectomy for esophageal cancer has been performed as an alternative to open surgery to reduce surgical trauma. However, its effect on pulmonary function, exercise tolerability, and quality of life is unknown.


METHODS
Fifty-one patients with esophageal cancer underwent thoracic esophagectomy with radical lymphadenectomy by posterolateral thoracotomy (29 cases) or thoracoscopic surgery (22 cases). Patients performed spirometry and exercise tolerance testing and completed a quality-of-life questionnaire before and 3 months after surgery.


RESULTS
Pre-to-postoperative change in vital capacity was 74.3 +/- 10.6% in the thoracotomy group and 84.9 +/- 10.4% in the thoracoscopy group (p = 0.021). Maximum oxygen uptake was similar, but dyspnea was the more common factor limiting exercise tolerance postoperatively in the thoracotomy group. Change in pre-to-postoperative performance status was 1.20 +/- 0.62 in the thoracotomy group and 0.55 +/- 0.51 in the thoracoscopy group (p = 0.0003).


CONCLUSIONS
Thoracoscopic esophagectomy for esophageal cancer has better preservation of pulmonary function and quality-of-life.
Taguchi
S
S
Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. m8450735@msic.med.osaka-cu.ac.jp
Osugi
H
H
Higashino
M
M
Tokuhara
T
T
Takada
N
N
Takemura
M
M
Lee
S
S
Kinoshita
H
H
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004417:Dyspnea / Q000209:etiology / Q000523:psychology; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006801:Humans; D015993:Life Tables; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000523:psychology; D011788:Quality of Life; D012129:Respiratory Function Tests; D013147:Spirometry; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome