Short-Term Outcomes Following Minimally Invasive and Open Esophagectomy: A Population-Based Study from Finland and Sweden

被引：39

作者：

Kauppila, Joonas H. ^{[1
,2
,3
]}

Helminen, Olli ^{[2
,3
,4
]}

Kyto, Ville ^{[5
,6
]}

Gunn, Jarmo ^{[5
,7
]}

Lagergren, Jesper ^{[1
,8
,9
]}

Sihvo, Eero ^{[4
]}

机构：

[1] Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Upper Gastrointestinal Surg, S-17176 Stockholm, Sweden

[2] Univ Oulu, Canc & Translat Med Res Unit, Med Res Ctr Oulu, Oulu, Finland

[3] Oulu Univ Hosp, Oulu, Finland

[4] Cent Finland Cent Hosp, Dept Surg, Jyvaskyla, Finland

[5] Turku Univ Hosp, Ctr Heart, Turku, Finland

[6] Univ Turku, Res Ctr Appl & Prevent Cardiovasc Med, Turku, Finland

[7] Univ Turku, Dept Surg, Fac Med, Turku, Finland

[8] Kings Coll London, Div Canc Studies, London, England

[9] Guys & St Thomas NHS Fdn Trust, London, England

来源：

ANNALS OF SURGICAL ONCOLOGY | 2018年 / 25卷 / 01期

基金：

瑞典研究理事会;

关键词：

QUALITY-OF-LIFE; POSTOPERATIVE MORTALITY; CANCER; SURGERY; 30-DAY; SURVIVAL;

D O I：

10.1245/s10434-017-6212-9

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Population-based studies comparing minimally invasive esophagectomy (MIE) and open esophagectomy (OE) relative to 90-day postoperative mortality are needed. The aim of this study was to compare short-term outcomes following these two techniques for esophageal cancer. Patients undergoing MIE (n = 217) or OE (n = 1397) for esophageal cancer between 2007 and 2014 were identified from nationwide complete registries in Finland and Sweden. The primary outcome was 90-day mortality, and secondary outcomes were 30-day mortality, length of hospital stay, and 30- and 90-day readmission rate. Results were adjusted for age, sex, comorbidity, tumor histology, surgery year, and country. Ninety-day mortality rates were 4.1% (n = 9 of 217) for MIE and 6.8% (n = 95 of 1397) for OE; 90-day mortality was halved after MIE [adjusted hazard ratio (HR) 0.49, 95% confidence interval (CI) 0.24-0.99]. There was no difference in 30-day mortality (adjusted HR 0.87, 95% CI 0.29-2.66). Median hospital stay was 15 days for MIE and 16 days for OE (adjusted beta -0.17, standard error 0.08, p = 0.030). The 30-day readmission rates were 8.9% after MIE and 12.0% after OE (adjusted HR 0.57, 95% CI 0.34-0.94), while the 90-day readmission rates were 28.8% and 33.6%, respectively, without a statistically significant difference (adjusted HR 0.82, 95% CI 0.61-1.10). This population-based study from Finland and Sweden revealed lower 90-day mortality, shorter hospital stay, and lower 30-day readmission rates after MIE compared with OE for esophageal cancer. These findings support the use of minimally invasive approaches.

引用

页码：326 / 332

页数：7

共 31 条

[31] Superiority of Minimally Invasive Oesophagectomy in Reducing In-Hospital Mortality of Patients with Resectable Oesophageal Cancer: A Meta-Analysis [J].