Short-term efficacy of minimally invasive esophagectomy combined with three-field versus two-field lymphadenectomy for 257 patients

Zengfeng SUN; Junqiang LIU; Boshi FAN; Weian SONG; Caiying YUE; Shouying DI; Jiahua ZHAO; Shaohua ZHOU; Hai DONG; Jusi WANG; Siyu CHEN; Taiqian GONG

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Short-term efficacy of minimally invasive esophagectomy combined with three-field versus two-field lymphadenectomy for 257 patients

VernacularTitle:微创食管切除术联合三野或二野淋巴结清扫术治疗食管鳞状细胞癌257例近期疗效的回顾性队列研究
Author: Zengfeng SUN ¹ ; Junqiang LIU ² ; Boshi FAN ² ; Weian SONG ² ; Caiying YUE ² ; Shouying DI ² ; Jiahua ZHAO ² ; Shaohua ZHOU ² ; Hai DONG ² ; Jusi WANG ² ; Siyu CHEN ² ; Taiqian GONG ^{1
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Author Information

1. The Second Clinical College of Southern Medical University, Guangzhou, 510080, P. R. China
2. Department of Thoracic Surgery, Sixth Medical Center, Chinese People s Liberation Army General Hospital, Beijing, 100089, P. R. China
Publication Type:Journal Article
Keywords: Esophageal squamous cell carcinoma; minimally invasive esophagectomy; three-field lymphadenectomy; two-field lymphadenectomy
From: Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(04):556-561
CountryChina
Language:Chinese
Abstract: Objective To explore the safety of minimally invasive esophagectomy (MIE) with three-field lymphadenectomy (3-FL) for esophageal squamous cell carcinoma (ESCC) by comparing the short-term outcomes between the 3-FL and the two-field lymphadenectomy (2-FL) in MIE. Methods The clinical data of patients with ESCC who underwent minimally invasive McKeown esophagectomy in our hospital from July 2015 to March 2022 were collected retrospectively. Patients were divided into a 3-FL group and a 2-FL group according to lymph node dissection method. And the clinical outcomes and postoperative complications were compared between the two groups. Results A total of 257 patients with ESCC were included in this study. There were 211 males and 46 females with an average age of 62.2±8.1 years. There were 109 patients in the 3-FL group and 148 patients in the 2-FL group. The operation time of the 3-FL group was about 20 minutes longer than that of the 2-FL group (P<0.001). There was no statistical difference between the two groups in the intraoperatve blood loss (P=0.376). More lymph nodes (P<0.001) and also more positive lymph nodes (P=0.003) were obtained in the 3-FL group than in the 2-FL group, and there was a statistical difference in the pathological N stage between the two groups (P<0.001). But there was no statistical difference in the incidence of anastomotic leak (P=0.667), chyle leak (P=0.421), recurrent laryngeal nerve injury (P=0.081), pulmonary complications (P=0.601), pneumonia (P=0.061), cardiac complications (P=0.383), overall complications (P=0.147) or Clavien-Dindo grading (P=0.152) between the two groups. Conclusion MIE 3-FL can improve the efficiency of lymph node dissection and the accuracy of tumor lymph node staging, but it does not increase the postoperative complications, which is worthy of clinical application.