Comparison of therapeutic efficacy between Ivor-Lewis esophagectomy and 2-incision esophagectomy via left thoracic-cervical pathway in the treatment of middle thoracic esophageal carcinoma
10.3781/j.issn.1000-7431.2009.12.011
- VernacularTitle:改良Ivor-Lewis术与经左胸左颈二切口根治术治疗胸中段食管鳞癌疗效的比较
- Author:
Xiaofeng ZHU
;
Zhou WANG
;
Qingfu CHEN
;
Xiangyan LIU
;
Yang YU
;
Fanying LIU
- Publication Type:Journal Article
- Keywords:
Esophageal neoplasms;
Carcinoma;
squamous cell;
Surgical procedures;
operative;
Prognosis
- From:
Tumor
2009;(12):1153-1157
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To retrospectively evaluate the therapeutic efficacy of two different surgical approaches, Ivor-Lewis esophagectomy and 2-incision esophagectomy via left thoracic-cervical pathway, in the treatment of middle thoracic esophageal squamous cell carcinoma. Methods:One hundred and two patients from 167 patients with middle thoracic esophageal squamous cell carcinoma received Ivor-Lewis esophagectomy and another 65 patients received 2-incision esophagectomy via left thoracic-cervical pathway. The local recurrence rate of tumor and survival rate were calculated by using Kaplan-Meier method. The difference in the survival rate between the two surgical methods was analyzed by using log-rank test. The prognostic risk factors were assessed by COX regression analysis. Results:Peri-operative complications occurred in 35 patients (21.0%), in which the incidences of recurrent laryngeal nerve (RLN) injury and anastomotic leakage were higher in the left thoracic-cervical group (P<0.05), and the incidence of intrathoracic gastric retention was higher in the Ivor-Lewis group, but the difference was not significant. The 3-year local recurrence rate was 37.3% in the Ivor-Lewis group, and 40.0% in the left thoracic-cervical group. The difference was not significant (P>0.05). The overall 5-year survival rate of the 167 patients was 34.6%. It was 36.0% in the Ivor-Lewis group and 32.3% in the left thoracic-cervical group, respectively (P>0.05). COX regression analysis revealed that pTNM staging was the independent prognostic factor [P=0.000, HR(hazard ratio)=2.69]. Conclusion:Both Ivor-Lewis esophagectomy and 2-incision esophagectomy via left thoracic-cervical pathway are feasible alternatives in the treatment of middle thoracic esophageal squmamous cell carcinoma. We should choose the rational operative method based on the patients'individual condition.
