[Thoracoscopic subtotal esophageal resection for benign esophageal diseases]. / Torakoskopicheskaia subtotal'naia rezektsiia pishchevoda pri ego dobrokachestvennykh zabolevaniiakh.

ABSTRACT

AIM: To investigate the role of video-assisted subtotal esophageal resection in treatment of patients with benign esophageal diseases. MATERIAL AND METHODS: Fifty-one patients with benign esophageal diseases have undergone subtotal esophageal resection in our department for the period 2010-2017. Thoracoscopic technique was applied in 25 cases, open approach - in 26 patients. Total surgery time, thoracoscopic stage duration, length of hospital-stay (LOS), ICU-stay, Clavien-Dindo morbidity rates with separate registration of respiratory complications, mortality have been considered. RESULTS: Groups were similar in terms of age, gender, ASA status. Thoracoscopic stage duration gradually decreased from 175 to 65 min with average time of 102 (75; 123) min. Total surgery time was 390 (270; 495) min in group 1 and 465 (341; 561) min in the control group (р=0.035). Mean ICU-stay decreased up to 2 (1.25; 3.75) days compared with the control group (5 (3.92; 5.85) days, р<0.0001). Conversion rate was 8%. In the main group complications Clavien-Dindo grade 2 were detected in 10 (40%) patients compared with 20 (69%) cases in the control group (р=0.009). Respiratory complications occurred in 5 patients in group 1 and in 13 cases of the control group (р=0.039). Mortality was absent. CONCLUSION: Thoracoscopic subtotal esophageal resection may be advisable alternative to open surgery for patients with benign esophageal diseases due to lower postoperative morbidity and earlier rehabilitation followed by improved outcomes.