AIM: To compare lymph node dissection results of minimally invasive esophagectomy(MIE) and open surgery for esophageal squamous cell carcinoma.METHODS: We retrospectively reviewed data from patients who underwent MIE ...AIM: To compare lymph node dissection results of minimally invasive esophagectomy(MIE) and open surgery for esophageal squamous cell carcinoma.METHODS: We retrospectively reviewed data from patients who underwent MIE or open surgery for esophageal squamous cell carcinoma from January 2011 to September 2014. Number of lymph nodes resected, positive lymph node(p N+) rate, lymph node sampling(LNS) rate and lymph node metastatic(LNM) rate were evaluated. R E S U LT S : A m o n g 4 4 7 p a t i e n t s i n c l u d e d, 1 2 3 underwent MIE and 324 underwent open surgery. The number of lymph nodes resected did not significantly differ between the MIE and open surgery groups(21.1 ± 4.3 vs 20.4 ± 3.8, respectively, P = 0.0944). The p N+ rate of stage T3 esophageal squamous cell carcinoma in the open surgery group was higher than that in the MIE group(16.3% vs 11.4%, P = 0.031), but no differences was observed for stages T1 and T2 esophageal squamous cell carcinoma. The LNS rate at left para-recurrent laryngeal nerve(RLN) site was significantly higher for open surgery than for MIE(80.2% vs 43.9%, P < 0.001), but no differences were noted at other sites. The LNM rate at left para-RLN site in the open surgery group was significantly higher than that in the MIE group, regardless of pathologic T stage. CONCLUSION: For stages T1 and T2 esophageal squamous cell carcinoma, the lymph node dissection result after MIE was comparable to that achieved by open surgery. However, the efficacy of MIE in lymphadenectomy for stage T3 esophageal squamous cell carcinoma, particularly at left para-RLN site, remains to be improved.展开更多
Esophageal carcinoma(EC)is a common malignant tumor of the upper digestive tract worldwide.An analysis of the latest data from cancer centers in China showed that the incidence of EC and the number of deaths due to EC...Esophageal carcinoma(EC)is a common malignant tumor of the upper digestive tract worldwide.An analysis of the latest data from cancer centers in China showed that the incidence of EC and the number of deaths due to EC in China in 2015 were 266,000 and 188,000,respectively,ranking sixth(6.3%)and fourth(8.0%)among all malignant tumors.The early diagnosis and treatment of EC and standardized diagnosis and treatment are important tasks for EC healthcare professionals in various centers across the country.At present,the 8th edition of the EC staging system jointly released by Union for International Cancer Control(UICC)and American Joint Committee on Cancer(AJCC)is the most recent,authoritative and widely used EC staging standard.The EC professional committee of the Chinese Anti-Cancer Association also organizes the"EC Standardization Campaign in China"every year to promote the development of EC diagnostic and treatment norms throughout the country.Since 2011,the EC Committee of the Chinese Anti-Cancer Association has published the Guidelines for Standardized Diagnosis and Treatment of EC.Considering the increasing number of EC clinical studies and the continuous progress in diagnostic and treatment technologies in recent years,the updated Guidelines will include the latest progress in the diagnosis and treatment of EC,with a goal of promoting the forward development of EC diagnosis and treatment in clinical practice.展开更多
Purpose Anastomotic leakage(AL)is one of the most pernicious complications after esophagectomy for patients with esophageal or esophagogastric junction cancer(EC or EJC).The application of fibrin sealant(FS)may be adv...Purpose Anastomotic leakage(AL)is one of the most pernicious complications after esophagectomy for patients with esophageal or esophagogastric junction cancer(EC or EJC).The application of fibrin sealant(FS)may be advantageous for reducing the incidence of AL.This study aims to evaluate the safety and effectiveness of FS in preventing AL in patients undergoing McKeown esophagectomy.Methods In this multicenter,prospective,randomized controlled trial,we planned to recruit 360 patients aged 18–75 years with resectable EC or EJC and the interim analysis was performed when the number of participants reaches 180.Patients assigned to the FS group received McKeown esophagectomy with 2.5ml FS applied to the cervical anastomosis,while patients in the control group received surgery alone.The primary endpoint was the incidence of cervical AL within the first 3 months postoperatively.Result From February 2019 to November 2021,180 patients were recruited,with 89 in the FS group and 91 in the control group.There was no statistically difference between the incidence of AL between the two groups[6.7%(6/89)in the FS vs.14.3%(13/91)in the control group,P=0.16].Complications was comparable(P=0.76)between the FS group(42 of 89,47.2%)and the control group(45 of 91,49.5%).No adverse events related to FS or deaths occurred postoperatively.Conclusion The application of FS intraoperatively is feasible and does not increase the risk of complications,and its effectiveness for the prevention of AL needs to be revalidated after the completion of patient enrollment.Trial registration This trial was registered at ClinicalTrials.gov(NCT03847857)on February 19th,2019.展开更多
基金Supported by the National Natural Science Foundation of China,No.81372472
文摘AIM: To compare lymph node dissection results of minimally invasive esophagectomy(MIE) and open surgery for esophageal squamous cell carcinoma.METHODS: We retrospectively reviewed data from patients who underwent MIE or open surgery for esophageal squamous cell carcinoma from January 2011 to September 2014. Number of lymph nodes resected, positive lymph node(p N+) rate, lymph node sampling(LNS) rate and lymph node metastatic(LNM) rate were evaluated. R E S U LT S : A m o n g 4 4 7 p a t i e n t s i n c l u d e d, 1 2 3 underwent MIE and 324 underwent open surgery. The number of lymph nodes resected did not significantly differ between the MIE and open surgery groups(21.1 ± 4.3 vs 20.4 ± 3.8, respectively, P = 0.0944). The p N+ rate of stage T3 esophageal squamous cell carcinoma in the open surgery group was higher than that in the MIE group(16.3% vs 11.4%, P = 0.031), but no differences was observed for stages T1 and T2 esophageal squamous cell carcinoma. The LNS rate at left para-recurrent laryngeal nerve(RLN) site was significantly higher for open surgery than for MIE(80.2% vs 43.9%, P < 0.001), but no differences were noted at other sites. The LNM rate at left para-RLN site in the open surgery group was significantly higher than that in the MIE group, regardless of pathologic T stage. CONCLUSION: For stages T1 and T2 esophageal squamous cell carcinoma, the lymph node dissection result after MIE was comparable to that achieved by open surgery. However, the efficacy of MIE in lymphadenectomy for stage T3 esophageal squamous cell carcinoma, particularly at left para-RLN site, remains to be improved.
基金supported by China Anti-Cancer Association(CACA).
文摘Esophageal carcinoma(EC)is a common malignant tumor of the upper digestive tract worldwide.An analysis of the latest data from cancer centers in China showed that the incidence of EC and the number of deaths due to EC in China in 2015 were 266,000 and 188,000,respectively,ranking sixth(6.3%)and fourth(8.0%)among all malignant tumors.The early diagnosis and treatment of EC and standardized diagnosis and treatment are important tasks for EC healthcare professionals in various centers across the country.At present,the 8th edition of the EC staging system jointly released by Union for International Cancer Control(UICC)and American Joint Committee on Cancer(AJCC)is the most recent,authoritative and widely used EC staging standard.The EC professional committee of the Chinese Anti-Cancer Association also organizes the"EC Standardization Campaign in China"every year to promote the development of EC diagnostic and treatment norms throughout the country.Since 2011,the EC Committee of the Chinese Anti-Cancer Association has published the Guidelines for Standardized Diagnosis and Treatment of EC.Considering the increasing number of EC clinical studies and the continuous progress in diagnostic and treatment technologies in recent years,the updated Guidelines will include the latest progress in the diagnosis and treatment of EC,with a goal of promoting the forward development of EC diagnosis and treatment in clinical practice.
基金funded by the National Natural Science Foundation of China(grant numbers 81402003 and 81972614).
文摘Purpose Anastomotic leakage(AL)is one of the most pernicious complications after esophagectomy for patients with esophageal or esophagogastric junction cancer(EC or EJC).The application of fibrin sealant(FS)may be advantageous for reducing the incidence of AL.This study aims to evaluate the safety and effectiveness of FS in preventing AL in patients undergoing McKeown esophagectomy.Methods In this multicenter,prospective,randomized controlled trial,we planned to recruit 360 patients aged 18–75 years with resectable EC or EJC and the interim analysis was performed when the number of participants reaches 180.Patients assigned to the FS group received McKeown esophagectomy with 2.5ml FS applied to the cervical anastomosis,while patients in the control group received surgery alone.The primary endpoint was the incidence of cervical AL within the first 3 months postoperatively.Result From February 2019 to November 2021,180 patients were recruited,with 89 in the FS group and 91 in the control group.There was no statistically difference between the incidence of AL between the two groups[6.7%(6/89)in the FS vs.14.3%(13/91)in the control group,P=0.16].Complications was comparable(P=0.76)between the FS group(42 of 89,47.2%)and the control group(45 of 91,49.5%).No adverse events related to FS or deaths occurred postoperatively.Conclusion The application of FS intraoperatively is feasible and does not increase the risk of complications,and its effectiveness for the prevention of AL needs to be revalidated after the completion of patient enrollment.Trial registration This trial was registered at ClinicalTrials.gov(NCT03847857)on February 19th,2019.
