E.A. Kruglov, Y.A. Pobedintseva, V.A. Kudlachev, E.V. Philimonov, A.I. Iljin, E.V. Izmaylova, V.M. Unguryan
Kostroma Oncologic Dispensary, Kostroma
Kruglov E.A. — M.D., Chief of surgery unit No.1 of Regional State Funded Healthcare Facility “Kostroma Oncologic Dispensary”
19 Nizhnyaya Debrya St., Kostroma, Russian Federation 156005, tel.: (494) 239-81-23, +7-921-740-98-12, e-mail: seakruglov@gmail.com
Abstract.
Objective. Assessment of morbidity, operation time, and mortality in the introduction of minimally invasive surgical technologies in the surgery of esophageal cancer as exemplified by a regional cancer center. Materials and methods. A retrospective analysis of the first half of the learning curve of minimally invasive esophagectomy (MIE) was conducted, which represents the experience of operations in 40 patients who were operated with a thoracoscopic access for esophageal cancer. The patients were divided into two chronological groups according to the division of into 30 patients in each group for the study of the learning curve of MIE, 30 and 10 in groups A and B respectively. Duration of the operation and thoracoscopic stage separately, number of the removed lymph nodes, frequency of complications, mortality, and length of stay in the hospital were analyzed. Results. Dynamics and compliance of the trend of the learning curve with the curves given in the world literature were evaluated. At the same time, at all stages of introduction of the methodology, frequency of complications, time of operations and mortality corresponded to the data presented in the available international literature. Conclusion. Introduction of minimally invasive technologies to surgery of esophageal cancer is relatively safe and possible in a regional oncology hospital. Herewith, the first half of the learning curve in a regional hospital is comparable to the data presented in international literary sources.
Key words: esophageal cancer, thoracoscopy, learning curve, operative technique, preoperative assessment.