Zhao HC, Zhang S, Zhou L, Lou XL, Chen D, Shi CW, Ren Z. Effect of totally thoracoscopic esophagectomy on postoperative complications and serum inflammatory factors in patients with early esophageal cancer. World J Gastrointest Surg 2025; 17(10): 107760 [PMID: 41178888 DOI: 10.4240/wjgs.v17.i10.107760]
Corresponding Author of This Article
Zhe Ren, Associate Professor, Department of Cardiothoracic Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), No. 54 Youdian Road, Hangzhou 310000, Zhejiang Province, China. rzhe2046@sina.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Oct 27, 2025 (publication date) through Nov 15, 2025
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Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Zhao HC, Zhang S, Zhou L, Lou XL, Chen D, Shi CW, Ren Z. Effect of totally thoracoscopic esophagectomy on postoperative complications and serum inflammatory factors in patients with early esophageal cancer. World J Gastrointest Surg 2025; 17(10): 107760 [PMID: 41178888 DOI: 10.4240/wjgs.v17.i10.107760]
Heng-Chi Zhao, Xiao-Long Lou, Dong Chen, Cheng-Wei Shi, Zhe Ren, Department of Cardiothoracic Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou 310000, Zhejiang Province, China
Shuang Zhang, Lin Zhou, Department of Second Surgery, Shengzhou Hospital of Traditional Chinese Medicine, Shaoxing 312400, Zhejiang Province, China
Co-first authors: Heng-Chi Zhao and Shuang Zhang.
Author contributions: Zhao HC wrote the manuscript and reviewed the manuscript; Zhao HC Zhang S contributed equally to this article, they are the co-first authors of this manuscript; Zhao HC, Zhang S, Zhou L, Lou XL, Chen D, Shi CW, and Ren Z collected the data; and all authors annotated the manuscript.
Supported by Zhejiang Provincial Traditional Chinese Medicine Science and Technology Plan Project, No. 2023ZL424.
Institutional review board statement: This study was approved by the Medical Ethics Committee of The First Affiliated Hospital of Zhejiang Chinese Medical University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhe Ren, Associate Professor, Department of Cardiothoracic Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), No. 54 Youdian Road, Hangzhou 310000, Zhejiang Province, China. rzhe2046@sina.com
Received: May 20, 2025 Revised: June 22, 2025 Accepted: August 6, 2025 Published online: October 27, 2025 Processing time: 156 Days and 22.8 Hours
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.
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.
