Comparison of short-term outcomes between minimally invasive McKeown esophagectomy and Ivor-Lewis esophagectomy for esophageal cancer / 中南大学学报(医学版)

ABSTRACT

Objective:To summarize the outcomes of 74 patients with minimally invasive McKeown esophagectomy (MIE-McKeown),and to discuss the short-term outcomes by comparing with IvorLewis esophagectomy (ILE) procedure.Methods:A total of 74 patients with esophageal carcinoma underwent MIE-McKeown in Xiangya Hospital from November 2014 to July 2016 were retrospectively reviewed,and 85 patients underwent ILE procedure were selected as a control group.Perioperative and short-term outcomes were analyzed.Results:Compared with the ILE group,patients underwent MIE-McKeown had less blood loss,less pulmonary infection,longer resection length and more harvested lymph nodes (P＜0.05),but they had more anastomotic leakage and stricture rate,longer operation time and hospital stay as well (P＜0.05).The total rate of lymph node metastatic in all patients was 52.8％,and the rate of cervical lymph node metastases was 9.5％ in the MIE-McKeown group.Multiple carcinomas were found in 16 cases,and 7 were proximally located.The distance from the distal margin of the second lesion to the center of the main lesion was 20-85 (50.7±23.0) mm,while the distance in 9 second carcinomas distally located was 30-90 (57.8±20.5) mm.Conclusion:Compared with Ivor-Lewis esophagectomy procedure,MIE-McKeown procedure has a more complete lesion dissection and more harvested lymph nodes with smaller incisions,better short-term outcomes and more safety.It is an appropriate procedure for esophagectomy.However,it should be optimized for its high rate of anastomotic leakage and stricture.