Objective To explore the safety, effectiveness and economy of combined thoracoscopic and laparoscopic selective three-field lymphadenectomy with radical resection of esophageal carcinoma in the treatment of thoracic esophageal carcinoma. Methods The clinical data of 103 esophagectomy patients ever treated in our hospital from Jul 2012 to Feb 2016, with selective three-field lymphadenectomy by combined thoracoscopic and laparoscopic minimally invasive operation or open operation were retrospectively analyzed. The mortality rate, incidence of anastomotic leak, incidence of pulmonary infection, incidence of recurrent laryngeal nerve injury, number of harvested lymph nodes, and hospitalization costs between the patients with minimally invasive operation (minimal invasion group, 48 cases) and the patients with open operation (open operation group, 55 cases) were compared. Results There were statistically significant differences between the two groups in the incidence of arrhythmia, incidence of pulmonary infection, blood loss and operation time, incidence of hoarseness, while in the incidence of intraoperative death, chylothorax, dehiscence of abdominal incision, postoperative hemorrhoea and anastomotic leak, no significant difference was found. The minimal invasion group had a greater number of harvested lymph nodes with significant difference, and patients in the group cost more in the hospitalization expense. Conclusion It is safe to apply combined thoracoscopic and laparoscopic minimally invasive three-field lymphadenectomy with radical resection of esophageal carcinoma in the treatment of thoracic esophageal carcinoma, but the hospitalization expense would be higher. |