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Long-Term Outcomes of Carbon Dioxide Insufflation in Thoracoscopic Esophagectomy After Neoadjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma: A Retrospective Cohort Study.
Otsuka, Koji; Goto, Satoru; Ariyoshi, Tomotake; Yamashita, Takeshi; Saito, Akira; Kohmoto, Masahiro; Kato, Rei; Motegi, Kentaro; Yajima, Nobuyuki; Murakami, Masahiko.
Afiliación
  • Otsuka K; Esophageal Cancer Center, Showa University Hospital, Tokyo, JPN.
  • Goto S; Esophageal Cancer Center, Showa University Hospital, Tokyo, JPN.
  • Ariyoshi T; Esophageal Cancer Center, Showa University Hospital, Tokyo, JPN.
  • Yamashita T; Esophageal Cancer Center, Showa University Hospital, Tokyo, JPN.
  • Saito A; Esophageal Cancer Center, Showa University Hospital, Tokyo, JPN.
  • Kohmoto M; Esophageal Cancer Center, Showa University Hospital, Tokyo, JPN.
  • Kato R; Esophageal Cancer Center, Showa University Hospital, Tokyo, JPN.
  • Motegi K; Esophageal Cancer Center, Showa University Hospital, Tokyo, JPN.
  • Yajima N; Department of Medicine, Division of Rheumatology, Showa University School of Medicine, Tokyo, JPN.
  • Murakami M; Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, JPN.
Cureus ; 16(7): e65053, 2024 Jul.
Article en En | MEDLINE | ID: mdl-39171044
ABSTRACT

BACKGROUND:

Thoracoscopic esophagectomy (TE) with carbon dioxide (CO2) insufflation is increasingly performed for esophageal cancer; however, there is limited evidence of the long-term outcomes of CO2 insufflation on postoperative survival.

OBJECTIVES:

We investigated the long-term outcomes of TE with or without CO2 insufflation.

METHODS:

We enrolled 182 patients who underwent TE for esophageal cancer between January 2003 and October 2013 and categorized them into two groups with and without CO2 insufflation. The primary endpoint was five-year overall survival (5y-OS). Secondary endpoints included long-term outcomes, such as five-year relapse-free survival (5y-RFS) and five-year cancer-specific survival (5y-CSS), and short-term outcomes, such as surgical and non-surgical complications and reoperation within 30 days.

RESULTS:

Follow-up until death or the five-year postoperative period was 98.9% (median follow-up duration was six years in survivors). After adjusting for age, sex, and yield pathologic tumor, node, and metastasis (TNM) stage, we found no significant differences in 5y-OS (HR 1.12, 95% CI 0.66-1.91), 5y-RFS (HR 1.12, 95% CI 0.67-1.83), or 5y-CSS rates (HR 1.00, 95% CI 0.57-1.75). For short-term outcomes, significant intergroup differences in operation time (p=0.02), blood loss (p<0.001), postoperative length of stay (p<0.001), and incidence of atelectasis (p=0.004) were observed. The results of the sensitivity analysis were similar to the main results.

CONCLUSIONS:

In thoracoscopic procedures, CO2 insufflation significantly improved short-term outcomes, and it appears that the recurrence risk of esophageal cancer may not impact the long-term prognosis. While the influence of CO2 insufflation in thoracoscopic esophageal surgery remains unclear, our study suggests that the long-term prognosis is not compromised in other thoracic surgeries.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cureus Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cureus Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos