胸腔镜食管切除术 (TE) 吹入二氧化碳 (CO2) 越来越多地用于治疗食管癌；然而，关于 CO2 吹入对术后生存的长期结果的证据有限。我们研究了有或没有 CO2 吹入的 TE 的长期结果。我们招募了 182 名在 2003 年 1 月至 2013 年 10 月期间因食管癌接受 TE 的患者并将它们分为两组：有二氧化碳吹入和没有二氧化碳吹入。主要终点是五年总生存期（5y-OS）。次要终点包括长期结果，例如五年无复发生存率（5y-RFS）和五年癌症特异性生存率（5y-CSS），以及短期结果，例如手术和非手术并发症随访至死亡或术后五年的率为 98.9%（幸存者的中位随访时间为六年）。调整年龄、性别和产量病理肿瘤、淋巴结和转移 (TNM) 分期后，我们发现 5y-OS (HR 1.12, 95% CI 0.66-1.91)、5y-RFS (HR 1.12, 95) 没有显着差异。 % CI 0.67-1.83），或 5y-CSS 率（HR 1.00，95% CI 0.57-1.75）。对于短期结果，观察到手术时间（p=0.02）、失血量（p<0.001）、术后住院时间（p<0.001）和肺不张发生率（p=0.004）方面存在显着的组间差异。敏感性分析的结果与主要结果相似。在胸腔镜手术中，CO2 吹入显着改善了短期预后，而且食管癌的复发风险可能不会影响长期预后。虽然胸腔镜食管手术中二氧化碳吹入的影响尚不清楚，但我们的研究表明，其他胸腔手术的长期预后不会受到影响。版权所有 © 2024，Otsuka 等人。

Thoracoscopic esophagectomy (TE) with carbon dioxide (CO2) insufflation is increasingly performed for esophageal cancer; however, there is limited evidence of the long-term outcomes of CO2 insufflation on postoperative survival.We investigated the long-term outcomes of TE with or without CO2 insufflation.We enrolled 182 patients who underwent TE for esophageal cancer between January 2003 and October 2013 and categorized them into two groups: with and without CO2 insufflation. The primary endpoint was five-year overall survival (5y-OS). Secondary endpoints included long-term outcomes, such as five-year relapse-free survival (5y-RFS) and five-year cancer-specific survival (5y-CSS), and short-term outcomes, such as surgical and non-surgical complications and reoperation within 30 days.Follow-up until death or the five-year postoperative period was 98.9% (median follow-up duration was six years in survivors). After adjusting for age, sex, and yield pathologic tumor, node, and metastasis (TNM) stage, we found no significant differences in 5y-OS (HR 1.12, 95% CI 0.66-1.91), 5y-RFS (HR 1.12, 95% CI 0.67-1.83), or 5y-CSS rates (HR 1.00, 95% CI 0.57-1.75). For short-term outcomes, significant intergroup differences in operation time (p=0.02), blood loss (p<0.001), postoperative length of stay (p<0.001), and incidence of atelectasis (p=0.004) were observed. The results of the sensitivity analysis were similar to the main results.In thoracoscopic procedures, CO2 insufflation significantly improved short-term outcomes, and it appears that the recurrence risk of esophageal cancer may not impact the long-term prognosis. While the influence of CO2 insufflation in thoracoscopic esophageal surgery remains unclear, our study suggests that the long-term prognosis is not compromised in other thoracic surgeries.Copyright © 2024, Otsuka et al.