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Comparison of short-term therapeutic efficacy between minimally invasive Ivor-Lewis esophagectomy and Mckeown esophagectomy for esophageal cancer

Xiaobin Hou, Zhipeng Ren, Bo Yang, Yang Liu

Objective: Minimal Invasive Esophagectomy (MIE) has become the main radical treatment for esophageal cancer. However, there are still many controversies on MIE. This paper compared the shortterm therapeutic efficacy between minimally invasive Ivor-Lewis esophagectomy and McKeown esophagectomy for esophageal cancer.

Methods: The clinical data of patients with esophageal cancer treated by MIE from November 2014 to May 2016 in the PLA General Hospital (Beijing, China) were analysed retrospectively. The baseline and intraoperative data and postoperative outcomes were compared.

Results: There were 185 patients in total, including 120 patients in Ivor-Lewis group and 65 patients in McKeown group. There was no significant difference in baseline data between two groups. However, the location of tumors in the Ivor-Lewis group was mainly located in the middle-lower thoracic region, while the position of tumors in the McKeown group was mainly located in the middle-upper thoracic region. The operation time of the Ivor-Lewis group (314 ± 45 min) was slightly longer than that of the McKeown group (303 ± 37 min). The incidence of anastomotic leakage and recurrent laryngeal nerve injury in Ivor-Lewis group was significantly lower than that in McKeown group (2.5% (3/120) vs. 12.3% (8/65), 0.8% (1/120) vs. 9.2% (6/65)).

Conclusions: Compared with minimally invasive McKeown esophagectomy, Ivor-Lewis esophagectomy has lower incidence of anastomotic leakage and recurrent laryngeal nerve paralysis, but can complete thorough lymph node dissection and accurate staging.