Comparative analysis on the classic and modified Ivor-Lewis procedure in the treatment of mid-low thoracic esophageal carcinoma / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To retrospectively evaluate the efficacy of classic and modified Ivor-Lewis surgical procedure in the treatment of mid-low thoracic esophageal cancer.</p><p><b>METHODS</b>Clinical data of 140 patients with middle-lower thoracic esophageal cancer undergoing modified Ivor-Lewis esophagectomy from March 2009 to April 2010 (modified group) and 112 patients with same disease undergoing classic Ivor-Lewis esophagectomy from April 2010 to April 2011 in our department were collected. Operative time, surgical complications, total number of harvested lymph node, distribution of lymph nodes, lymph node metastasis rate, as well as postoperative pathological stage were compared between two groups.</p><p><b>RESULTS</b>There were no significant differences between two groups in general informations, operative time and surgical complications (P>0.05). The number of harvested superior mediastinum lymph nodes in classic Ivor-Lewis group was significantly more than that in modified group (8.0±2.1 vs. 3.1±0.6, P<0.05). Ratio of postoperative positive lymph node metastasis was significantly higher in classic Ivor-Lewis group as compared to modified group[41.1% (46/112) vs. 27.9% (39/140), P<0.05].</p><p><b>CONCLUSION</b>As compared to modified Ivor-Lewis procedure, classic Ivor-Lewis procedure is better in the resection of superior mediastinum lymph node and the evaluation of postoperative pathological stage, therefore it conforms better to the principle of cancer treatment of esophageal carcinoma.</p>