Effect of totally thoracoscopic esophagectomy on postoperative complications and serum inflammatory factors in patients with early esophageal cancer

Abstract

BACKGROUND

Although thoracotomy has been the conventional treatment for patients with early esophageal cancer (EEC), its drawbacks underscore the demand for more effective therapeutic strategies to improve surgical outcomes.

AIM

To comprehensively analyze the effect of totally thoracoscopic esophagectomy (TTE) on postoperative complications and serum inflammatory factors in patients diagnosed with EEC.

METHODS

A total of 113 patients with EEC, who were admitted to our hospital between September 2022 and December 2024, were recruited for this study. Specifically, 55 patients were assigned to the control group and underwent conventional surgical procedures, whereas 58 patients formed the research group and underwent TTE. Subsequently, a series of comparisons and analyses were conducted between the two groups. These comparisons included surgery-related parameters, such as incision length, operation duration, and the number and extent of lymph node dissection; postoperative complications, namely, empyema, pulmonary infection, incision infection, anastomotic fistula, and delayed gastric emptying; postoperative pain, which was quantitatively evaluated by the Numerical Rating Scale; postoperative hospitalization duration; serum inflammatory factors, including interleukin (IL)-6, IL-8, and tumor necrosis factor-α; and stress response-associated indicators, such as C-reactive protein, cortisol, and adrenaline.

RESULTS

Statistical data demonstrated that compared with the control group, the research group exhibited substantially shorter incision length and postoperative hospitalization duration. The two groups had comparable number and extent of lymph node dissection. Notably, both the overall incidence of postoperative complications and the Numerical Rating Scale score on postoperative day 3 were remarkably lower in the research group. Although the levels of IL-6, IL-8, tumor necrosis factor-α, C-reactive protein, cortisol, and adrenaline in the research group increased statistically postoperatively, they were still considerably lower than those in the control group.

CONCLUSION

In patients with EEC, TTE not only reduces the risk of postoperative complications but also effectively alleviates the body’s inflammatory and stress responses associated with surgery.

Keywords: Totally thoracoscopic esophagectomy; Early esophageal cancer; Postoperative complications; Serum inflammatory factors; Inflammation; Stress response; Clinical outcomes

Core Tip: Currently, evidence on totally thoracoscopic esophagectomy for early esophageal cancer is limited. This study confirms that compared to conventional surgery, this approach minimizes incision size, decreases hospitalization, reduces complications, lessens pain on postoperative day 3, and attenuates inflammatory stress. The finding supports its role as a clinically superior approach and a valuable reference for optimizing treatment strategies while furnishing practitioners with clinically relevant reference data.