摘要
Abstract
Objective To compare the efficacy and safety of minimally invasive esophagectomy(MIE)versus open esophagectomy(OE)in patients with locally advanced esophageal squamous cell carcinoma(ESCC)following neoadjuvant immunochemotherapy(nICT).Methods A retrospective analysis was conducted on 164 ESCC patients who underwent surgery after nICT at Northern Jiangsu People's Hospital from January 2021 to January 2024.Patients were divided into the MIE group(n=75)and OE group(n=89).Perioperative parameters,nutritional-inflammatory indicators and survival data were compared between the two groups.Results Compared with the OE group,MIE group showed significantly less intraoperative blood loss,more right recurrent laryngeal nerve lymph nodes harvested,shorter postoperative hospital stay,lower 24-hour drainage volume,lower 24-hour pain scores,and lower incidence of postoperative complications(pulmonary infection,arrhythmia,and pleural effusion)(all P<0.05).OE group had shorter operation time(P<0.05).No signifi-cant differences were observed between MIE and OE groups in total lymph node yield,left recurrent laryngeal nerve lymph node dissection,R0 resection rate,incidence of postoperative complications(anastomotic leakage,anastomotic stenosis,respiratory insufficiency,chylothorax,hoarseness,wound infection,and reoperation,etc.),overall survival rate and dis-ease-free survival rate(all P>0.05).Postoperatively,both groups showed increased C-reactive protein/albumin ratio(CAR)and systemic immune-inflammation index(SII),and decreased prognostic nutritional index(PNI).OE group had higher CAR and SII,and lower PNI than MIE group(all P<0.05).Conclusions For locally advanced ESCC patients re-ceiving nICT,both MIE and OE can achieve satisfactory therapeutic effect.However,MIE demonstrates superior advan-tages in perioperative safety,control of systemic stress response and enhanced recovery.关键词
微创食管切除术/开放食管切除术/新辅助免疫化疗/食管鳞状细胞癌Key words
minimally invasive esophagectomy/open esophagectomy/neoadjuvant immunochemotherapy/esopha-geal squamous cell carcinoma分类
医药卫生
