Thoraco-laparoscopic versus open McKeown esophagectomy for esophageal cancer: comparative outcomes on inflammatory response and coagulation function
Year: 2026
Type: article
Study design: Observational Study
Abstract: We aimed to unravel the efficacy of thoraco-laparoscopic combined McKeown esophagectomy for esophageal cancer and its impact on inflammatory response and coagulation function. We retrospectively analyzed 108 esophageal cancer patients, divided into thoraco-laparoscopic (TLE) and open esophagectomy (OE) groups. Observed indicators included surgical parameters (operative time, blood loss, ICU and hospital stays), inflammatory markers [white blood cell (WBC), neutrophil percentage (NEUT%), lymphocyte percentage (LYMPH%), platelet (PLT)], coagulation profiles [prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D)], complications, and 1-year disease-free survival. The TLE group demonstrated reduced intraoperative blood loss, shorter ICU and total hospital stays, and lower complication rates than the OE group (P<0.05). Postoperative inflammatory and coagulation profiles also differed, with TLE showing lower WBC (11.35±2.58 vs 12.48±2.41 109/L), NEUT% (72.28±6.62 vs 79.41±6.94%), PLT (233.87±19.62 vs 245.56±22.79 109/L), PT (11.41±0.79 vs 12.00±1.05 s), APTT (26.70±3.60 vs 28.83±3.08 s), and INR (0.90±0.07 vs 0.95±0.10), but higher LYMPH% (21.80±4.06 vs 19.52±4.16 %), D-D (348.89±37.92 vs 315.27±36.74 μg/L), and FIB (3.95±0.56 vs 3.71±0.51 g/L) levels than the OE group (P<0.05). TLE was an effective and reliable approach associated with fewer complications and comparable one-year oncologic outcomes to open surgery, though its effects on coagulation parameters warrant closer clinical monitoring.
Authors: Zhengqiao Wang, Renquan Zhang
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,600
OpenAlex ID: W7224802031