Objective:To investigate the clinical efficacy of Da Vinci robot-assisted superior mediastinum lymph node dissection around recurrent laryngeal nerve.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 404 patients with esophageal cancer who underwent Da Vinci robot-assisted esophagectomy in Tianjin Medical University Cancer Hospital and Institute from June 2017 to June 2022 were collected. There were 349 males and 55 females, aged (62±8)years. Observation indicators: (1) intraoperative conditions; (2) postoperative conditions; (3) comparison of clinical features in patients who were admitted in different time periods. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the one way ANOVA. Measurement data with skewed distribution were represented as M(IQR), and comparison among multiple groups was conducted using the Kruskal-Wallis H test. Count data were described as absolute numbers or percentages, and com-parison between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Intraoperative conditions. The operation time, volume of intraoperative blood loss, the total number of lymph node dissected, the number of thoracic lymph node dissected, left recurrent laryngeal nerve lymph node dissection rate, the number of left recurrent laryngeal nerve lymph node dissected, left recurrent laryngeal nerve lymph node metastasis rate, right recurrent laryngeal nerve lymph node dissection rate, the number of right recurrent laryngeal nerve lymph node dissected, right recurrent laryngeal nerve lymph node metastasis rate were (306±56)minutes,200(100)mL, 29.9±13.1, 18.5±9.7, 78.47%(317/404), 4.0(3.0), 17.35%(55/317), 94.55%(382/404), 3.0(2.0), 21.20%(81/382). (2) Postoperative conditions. The tumor histopathological type (squamous cell carcinoma, neuroendocrine carcinoma, adenocarcinoma, carcinosarcoma, adenosquamous carcinoma, malignant melanoma), incidence rate of overall complications, cases with recurrent laryngeal nerve paralysis, cases with pulmonary complications, cases with anastomotic fistula, cases with incision infection, cases with chylothorax, cases with arrhythmia, cases with deep vein thrombosis, cases with other complications, incidence of re-admission to the intensive care unit, duration of postoperative hospital stay, 90-day mortality were 377, 11, 7, 5, 3, 1, 27.48%(111/404), 8.91%(36/404), 10.64%(43/404), 6.93%(28/404), 0.99%(4/404), 2.48%(10/404), 1.73%(7/404), 0.50%(2/404), 1.98%(8/404), 6.93%(28/404), 16(11)days, 0.50%(2/404). (3) Comparison of clinical features in patients who were admi-tted in different time periods. The number of patients who were admitted from June 2017 to May 2018, from June 2018 to May 2019, from June 2019 to May 2020, from June 2020 to May 2021, from June 2021 to June 2022 was 40, 56, 57, 116, 135, respectively. There were significant differences in age, tumor histopathological type, pT staging, neoadjuvant therapy, operation time, volume of intra-operative blood loss, the total number of lymph node dissected, the number of thoracic lymph node dissected, left recurrent laryngeal nerve lymph node dissection rate, the number of left recurrent laryngeal nerve lymph node dissected, the number of right recurrent laryngeal nerve lymph node dissected, incidence rate of overall complications among patients who were admitted in different time periods ( P<0.05). Conclusion:The Da Vinci robot-assisted superior mediastinum lymph node dissection around recurrent laryngeal nerve is safe and feasible, which can achieve good short-term efficacy.

Esophagectomy and lymph node dissection are the cornerstones for the treatment of esophageal cancer. Upper mediastinal lymph node dissection is of great value for accurate staging and improving the prognosis of patients. Lymph node dissection along the left recurrent laryngeal nerve is the most challenging procedures in esophageal surgery, and there has been no relevant consensus on the scope and boundary of lymph node dissection. In recent years, with the application of endoscopic technology, especially robotic surgery system in esophagectomy, and the introduction of the concept of superior mediastinal microdissection, the authors have proposed the border of lymph node dissection along the left recurrent laryngeal nerve, so as to achieve precise, radical and standardized dissection. Combined with their own experiences, the authors elaborate on the anatomic boundary, extent and technique of lymph node dissection along the left recurrent laryngeal nerve.

Objective: To evaluate the prognostic value of the preoperative Geriatric Nutritional Risk Index (GNRI) in patients with esophageal squamous cell carcinoma after radical resection. Methods: Clinicopathological and laboratory data of 315 elderly patients with esophageal squamous cell carcinoma who were older than 60 years and underwent radical resection in Tianjin Medical University Cancer Institute and Hospital from January 2008 to December 2012 were retrospectively analyzed. The GNRI formula was as follows:1.489×serum albumin (g/L)+41.7×(current body weight/ideal body weight). According to the GNRI, patients were divided into the normal and abnormal GNRI groups. The χ2 test was used to analyze the relationship between the GNRI and the clinicopathological char-acteristics of patients. The Kaplan-Meier method was used to analyze the survival rate, and survival analysis was conducted using the Log-rank test. Multivariate survival analysis was conducted using the Cox proportional risk regression model. Results: There were 259 patients in the normal GNRI group (GNRI>98) and 56 patients in the abnormal GNRI group (GNRI≤98). The GNRI was closely correlated with age, tumor location, tumor diameter, serum albumin level, body mass index (BMI), and lymph node metastasis (all P<0.05). The 5-year survival rates in the normal and abnormal GNRI groups were 41.2% and 27.0%, respectively, with statistical significance (P=0.002). Univariate analysis showed that age, tumor diameter, serum albumin level, BMI, GNRI, platelet-lymphocyte ratio, tumor invasion depth, and lymph node metastasis were risk factors for the prognosis of patients with esophageal squamous cell carcinoma (all P<0.05). Multivariate analysis showed that the preoperative GNRI (hazard ratio=0.687, 95% confidence interval: 0.487-0.968, P=0.032) was an independent factor affecting the prognosis of patients with esophageal squamous cell carcinoma. Subgroup analysis showed that the survival rates in the normal GNRI group were significantly higher than those in the abnormal GNRI group (P=0.036 and 0.010, respectively), regardless of lymph node metastasis. Conclusions: The preoperative GNRI is associated with malignant biological behav-ior in elderly patients with esophageal squamous cell carcinoma and can be used as a useful indicator for predicting survival after radi-cal resection.

Programmed cell death protein 1 (PD-1/CD279) and cytotoxic T Lymphocyte Antigen-4 (CTLA-4) are important immune checkpoints, through the role of the corresponding ligands and inhibit T cell activation and production of cytokines, in maintaining the body′s vital role in peripheral tolerance. The use of anti-CTLA-4/PD-1/PD-L1 monoclonal antibodies to block the tumor signaling pathway has shown excellent anti-tumor efficacy in a variety of solid tumors, and it is expected that immunotherapy will be available for the treatment of 60% advanced tumors in the next decade. Esophageal cancer is one of the major causes of cancer-related deaths worldwide, and its 5-year survival rate is generally low. Currently, radiotherapy, chemotherapy, and surgery are the standard treatments for esophageal cancer, and there is no effective treatment scheme for patients with esophageal cancer who fail to respond to standard treatment. Due to the diversity of somatic cell gene mutations and the generation of neo-antigens in esophageal cancer, immunotherapy has become a feasible treatment scheme to improve the prognosis of esophageal cancer. In this situation, the application of immunotherapy for esophageal cancer or more specific immune checkpoint inhibitors has gradually become the focus of the treatment of esophageal cancer. Nowadays, the research of immune checkpoint inhibitors, such as ipilimumab, tremelimumab, pembrolizumab, nivolumab and avelumab on esophageal cancer is proceeding at an amazing speed. The phase Ⅰ b clinical study of immunotherapy for esophageal cancer, which previously attracted great interest, has been replaced by the phase Ⅲ clinical study, and the results of the relevant studies also show a good prospect for the application of immune checkpoint inhibitors for esophageal cancer. However, the prediction of therapeutic effect and the selection of the best candidates still need to be further studied.

Programmed cell death protein 1 (PD?1 / CD279) and cytotoxic T Lymphocyte Antigen?4 (CTLA?4) are important immune checkpoints, through the role of the corresponding ligands and inhibit T cell activation and production of cytokines, in maintaining the body′s vital role in peripheral tolerance. The use of anti?CTLA?4/PD?1/PD?L1 monoclonal antibodies to block the tumor signaling pathway has shown excellent anti?tumor efficacy in a variety of solid tumors, and it is expected that immunotherapy will be available for the treatment of 60% advanced tumors in the next decade. Esophageal cancer is one of the major causes of cancer?related deaths worldwide, and its 5?year survival rate is generally low. Currently, radiotherapy, chemotherapy, and surgery are the standard treatments for esophageal cancer, and there is no effective treatment scheme for patients with esophageal cancer who fail to respond to standard treatment. Due to the diversity of somatic cell gene mutations and the generation of neo?antigens in esophageal cancer, immunotherapy has become a feasible treatment scheme to improve the prognosis of esophageal cancer. In this situation, the application of immunotherapy for esophageal cancer or more specific immune checkpoint inhibitors has gradually become the focus of the treatment of esophageal cancer. Nowadays, the research of immune checkpoint inhibitors, such as ipilimumab, tremelimumab, pembrolizumab, nivolumab and avelumab on esophageal cancer is proceeding at an amazing speed. The phase Ⅰb clinical study of immunotherapy for esophageal cancer, which previously attracted great interest, has been replaced by the phaseⅢclinical study, and the results of the relevant studies also show a good prospect for the application of immune checkpoint inhibitors for esophageal cancer. However, the prediction of therapeutic effect and the selection of the best candidates still need to be further studied.

Programmed cell death protein 1 (PD?1 / CD279) and cytotoxic T Lymphocyte Antigen?4 (CTLA?4) are important immune checkpoints, through the role of the corresponding ligands and inhibit T cell activation and production of cytokines, in maintaining the body′s vital role in peripheral tolerance. The use of anti?CTLA?4/PD?1/PD?L1 monoclonal antibodies to block the tumor signaling pathway has shown excellent anti?tumor efficacy in a variety of solid tumors, and it is expected that immunotherapy will be available for the treatment of 60% advanced tumors in the next decade. Esophageal cancer is one of the major causes of cancer?related deaths worldwide, and its 5?year survival rate is generally low. Currently, radiotherapy, chemotherapy, and surgery are the standard treatments for esophageal cancer, and there is no effective treatment scheme for patients with esophageal cancer who fail to respond to standard treatment. Due to the diversity of somatic cell gene mutations and the generation of neo?antigens in esophageal cancer, immunotherapy has become a feasible treatment scheme to improve the prognosis of esophageal cancer. In this situation, the application of immunotherapy for esophageal cancer or more specific immune checkpoint inhibitors has gradually become the focus of the treatment of esophageal cancer. Nowadays, the research of immune checkpoint inhibitors, such as ipilimumab, tremelimumab, pembrolizumab, nivolumab and avelumab on esophageal cancer is proceeding at an amazing speed. The phase Ⅰb clinical study of immunotherapy for esophageal cancer, which previously attracted great interest, has been replaced by the phaseⅢclinical study, and the results of the relevant studies also show a good prospect for the application of immune checkpoint inhibitors for esophageal cancer. However, the prediction of therapeutic effect and the selection of the best candidates still need to be further studied.

Objective To investigate the clinical efficacy of minimally invasive esophagectomy and open triple-incision esophagectomy for esophageal cancer (EC).Methods The retrospective cohort study was conducted.The clinicopathological data of 454 EC patients who were admitted to the Tianjin Medical University Cancer Institute and Hospital from January 2012 to September 2016 were collected.Of 454 patients,229 undergoing thoracoscopic esophagectomy (194) or combined thoracoscopic + laparoscopic esophagectomy (35) were allocated into the minimally invasive group,and 225 undergoing open triple-incision esophagectomy in the left cervical,right chest and epigastric regions were allocated into the open group.Observation indicators:(1) intraoperative situations;(2) postoperative recovery situations;(3) stratified analysis;(4) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative survival up to October 2017.Measurement data with normal distribution were represented as-x±s,and t test was used for comparison between groups.Measurement data with skewed distribution were described as M (range),non-parametric test was used for comparison between groups.Count data were expressed as percentage,and the chi-square test or fisher exact probability method were used to test comparison between groups.KaplanMeier method was used to calculate survival rate and draw survival curve.Log-rank test was used for survival analysis.Results (1) Intraoperative situations:operation time,numbers of upper mediastina lymph node dissected and right laryngeal nerve lymph node dissected in stage 0-Ⅱ of TNM staging and numbers of neck lymph nodes dissected in stage Ⅲ of TNM staging were respectively (307±70)minutes,4 (range,0-18),2 (range,0-10),0 (range,0-24) in the minimally invasive group and (267±49)minutes,3 (range,0-15),1 (range,0-7),0 (range,0-46) in the open group,with statistically significant differences between groups (t =7.071,Z=-2.207,-2.717,-1.969,P＜0.05).(2) Postoperative recovery situations:thoracic drainage-tube removal time and volume of drainage fluid were respectively 5 days (range,2-88 days),280 mL (range,0-7 792 mL)in the minimally invasive group and 8 days (range,1-72 days),1 650 mL (range,225-7 970 mL),with statistically significant differences between groups (Z =-9.618,-15.443,P ＜ 0.05).The cases with total postoperative complications,arrhythmia and recurrent laryngeal nerve paralysis were 72,20,35 in the minimally invasive group and 100,36,56 in the open group,with statistically significant differences between groups (x2=8.155,5.542,6.533,P＜0.05).Patients may be combined with multiple complications.Two patients died within 30 days postoperatively,including 1 with respiratory failure and 1 with pulmonary embolism.Patients with other complications were improved after symptomatic and supportive treatments.(3) Stratified analysis:of 229 patients in the minimally invasive group,93 underwent surgery within the physician's learning curve and 136 underwent surgery after physician's learning curve.Operation time,volume of intraoperative blood loss,dissected numbers of upper mediastina lymph node,right laryngeal nerve lymph node,left laryngeal nerve lymph node,middle mediastinal lymph node and lower mediastinal lymph node,cases with pneumonia,recurrent laryngeal nerve paralysis,chylothorax,anastomotic stenosis,anastomotic fistula,respiratory failure and pulmonary embolism in 93 patients were respectively (306±68)minutes,(217± 178)mL,3 (range,0-20),2 (range,0-8),0 (range,0-10),6(range,0-17),1 (range,0-6),5,16,1,5,3,2,2 in the minimally invasive group and (308±72)minutes,(200±112)mL,4 (range,0-37),2 (range,0-10),0 (range,0-8),7 (range,0-20),1 (range,0-10),4,19,3,3,4,4,0 in the open group,with a statistically significant difference in number of upper mediastina lymph node dissected between groups (Z=-2.472,P＜0.05) and no statistically significant difference in other indicators between groups (t =-0.160,0.917,Z =-0.113,-1.698,-0.950,-0.510,x2 =0.342,0.446,P＞0.05).(4) Follow-up and survival situations:of 454 patients,415 were followed up for 1-62 months,with a median time of 28 months.Among the 415 patients,operation time ≥ 3 years was detected in 162 patients,(77 in the minimally invasive group and 85 in the open group),and 3-year cumulative survival rates of the minimally invasive and open groups were 68.1％ and 53.8％,showing no statistically significant difference between groups (x2=3.293,P＞0.05).Further subgroup analysis showed that postoperative 3-year cumulative survival rates of patients with the stage Ⅰ-Ⅱ and Ⅲ of TNM staging were respectively 82.1％,53.7％ in the minimally invasive group and 62.6％,48.6％ in the open group,showing no statistically significant difference between groups (x2=2.664,0.382,P＞ 0.05).Conclusion Minimally invasive esophagectomy has some characteristics of less surgical trauma postoperative complications,and its resection effect is comparable to open esophagectomy.

Objective To investigate the effect of the number of lymph nodes examined (NLNE) on the prognosis of esophageal squamous cell carcinoma (ESCC).Methods The retrospective case-control study was conducted.The clinicopathological date of 628 ESCC patients who underwent radical resection in the Tianjin Medical University Cancer Institute and Hospital from January 2005 to March 2013 was collected.Patients underwent radical resection of ESCC through right thorax.Observation indicators:(1) surgical and postoperative pathological examinations;(2) follow-up and survival situations;(3) effect of NLNE on the prognosis of ESCC;(4) factors analysis affecting prognosis of ESCC patients;(5) subgroup analysis.Follow-up using outpatient examination,telephone interview and mail was performed to detect postoperative survival up to February 2018.Measurement data with skewed distribution were described as M (range).Receiver operating characteristic (ROC) curve analysis was used to determine the appropriate cut-off of the NLNE.The survival curve and survival rate were respectively drawn and calculated by the Kaplan-Meier method,and the survival analysis was done by the log-rank test.Multivariate analysis was done by the Cox proportional hazard model.Results (1) Surgical and postoperative pathological examinations:472 and 156 patients underwent respectively Ivor-Lewis and Mckeown operations.There were 284 patients with tumor diameter ≤ 3.5 cm and 344 patients with tumor diameter ＞ 3.5 cm.The total NLNE was 11 139 for all of the 628 patients,with an average NLNE of 18 per case(range,2-78 per case) and a median NLNE of 16 per case.Of 628 patients,high-,moderate-and low-differentiated tumors were respectively detected in 48,469 and 111 patients;staging T0-1,T2,T3 and T4a of depth of tumor invasion in 30,119,260 and 219 patients;N0,N1,N2 and N3 of degree of lymph node metastasis in 349,173,69 and 37 patients;rN0,rN1,rN2 and rN3 of rate of lymph node metastasis in 349,184,54 and 41 patients.(2) Follow-up and survival situations:all the 628 patients were followed up for 3-144 months,with a median time of 36 months.The 1-,3-and 5-year survival rates were 82.4％,53.7％ and 41.3％,respectively.(3)Effect of NLNE on the prognosis of ESCC:ROC curve showed that the appropriate cut-off value of the NLNE was 16.Using NLNE =16 as a cut-off value,5-year survival rate was respectively 36.7％ in patients with NLNE ＜ 16 and 45.1％ in patients with NLNE ≥ 16,with a statistically significant difference in survival (x2 =9.527,P＜0.05).According to a median NLNE of 23,the patients with NLNE ≥ 16 were further divided into patients with 16 ≤ NLNE ≤ 23 and NLNE ＞ 23.Results showed that 5-year survival rate in patients with NLNE ＜ 16,16 ≤ NLNE ≤ 23 and NLNE ＞ 23 was respectively 36.7％,41.2％ and 50.3％,with a statistically significant difference in survival among them (x2 =10.588,P＜0.05),between patients with NLNE ＜ 16 and 16 ≤ NLNE ≤ 23 (x2 =4.419,P＜0.05).There was no statistically significant difference between patients with 16 ≤ NLNE ≤ 23 and NLNE ＞ 23 (x2 =1.413,P＞0.05).Five-year survival rate in patients with NLNE ≤ 23 and NLNE ＞23 was respectively 38.6％ and 50.3％,with a statisctically significant difference (x2 =5.885,P＜0.05).(4)Factors analysis affecting prognosis of ESCC patients:results of univariate analysis showed that age,smoking history,BMI,tumor diameter,NLNE,depth of tumor invasion,degree and rate of lymph node metastasis were related factors affecting the prognosis of ESCC patients (x2 =5.454,4.875,7.669,10.691,10.588,30.612,59.780,76.565,P＜0.05).Results of muhivariate analysis showed that age,tumor diameter,NLNE,depth of tumor invasion and rate of lymph node metastasis were independent factors affecting the prognosis of ESCC patients [HR=1.268,1.300,0.762,1.354,1.357,95％ confidence interval (CI):1.034-1.556,1.038-1.629,0.662-0.878,1.183-1.549,1.089-1.692,P＜0.05].(5) Subgroup analysis:among 279 patients with lymph node metastasis,5-year survival rate in patients with NLNE ＜ 16,16 ≤ NLNE ≤ 23 and NLNE ＞ 23 was respectively 23.7％,19.4％ and 39.5％,with a statistically significant difference among them (x2 =8.397,P＜0.05),between patients with 16≤ NLNE ≤ 23 and NLNE ＞ 23 (x2=5.425,P＜0.05).There was no statistically significant difference between patients with NLNE ＜ 16 and 16 ≤ NLNE ≤ 23 (x2 =0.389,P＞ 0.05).Five-year survival rate in patients with NLNE ≤ 23 and NLNE ＞ 23 was respectively 21.9％ and 39.5％,with a statisctically significant difference (x2=7.942,P＜ 0.05).Among 349 patients without lymph node metastasis,5-year survival rate in patients with NLNE ＜ 16,16 ≤ NLNE ≤ 23 and NLNE ＞ 23 was respectively 45.6％,60.3％ and 59.2％,with a statistically significant difference among them (x2 =9.755,P＜0.05) and between patients with NLNE ＜ 16 and 16 ≤ NLNE ≤ 23 (x2 =8.208,P＜0.05).There was no statistically significant difference between patients with 16 ≤ NLNE ≤ 23 and NLNE ＞ 23 (x2 =0.284,P＞0.05).Five-year survival rate in patients with NLNE ≤ 23 and NLNE ＞ 23 was respectively 51.1％ and 59.2％,with no statisctically significant difference (x2 =1.147,P＞ 0.05).Conclusions The NLNE is an independent factor affecting the prognosis of ESCC patients,and at least 16 to 23 lymph nodes should be dissected.For patients with lymph node metastasis,and more than 23 lymph nodes should be dissected.For patients without lymph node metastasis,more than 23 lymph nodes dissection cannot obviously improve the prognosis of patients.

Objective The surgical approaches and extent of lymph node dissection for Siewert type Ⅱ adenocarcinoma of the esophagogastric junction(AEG) are controversial.The present study was aimed to investigate the application of right thansthoracic Ivor-Lewis(IL),left transthoracic(LTT),and left thoracoabdominal(LTA) approach in Siewert type Ⅱ AEG.Methods The data of 196 patients with Siewert type Ⅱ AEG received surgical resection in our cancer center between January 2014 and April 2016 was retrospectively analyzed.Finally,136 patients met the inclusion criteria were enrolled in the study and divided into the IL(47 cases),LTT(51 cases),and LTA group(38 cases).Clinical and short-term treatment effects were compared among the three groups.Results The patients with weight loss,diabetes,and heart disease increased in the LTT group (P =0.054,P =0.075,and P =0.063,respectively).Operation time was significantly longest in the IL group (P =0.000),but the amount of bleeding and tumor size did not significantly differ among the three groups (P =0.176 and P =0.228,respectively).The IL group had the significantly longest proximal surgical margin (P =0.000) and most number of total (P =0.000) and thoracic lymph nodes(P =0.000) dissected.Both the IL and LTA groups had more abdominal lymph nodes dissected than the LTT group(P =0.000).In general,the IL and LTT group had the highest dissection rates of every station of thoracic (P ＜ 0.05) and lower mediastinal lymph nodes (P ＜ 0.05),respectively.The dissection rate of the paracardial,left gastric artery,and gastric lesser curvature lymph nodes did not differ significantly among the three groups(P ＞ 0.05),but the dissection rate of the hepatic artery,splenic artery,and celiac trunk lymph nodes was significantly highest in the IL group (P ＜0.05).Postoperative hospital stay,perioperative complications,and mortality did not differ significantly among the three groups(P ＞ 0.05).Conclusion Compared with the traditional left transthoracic approach,the Ivor-Lewis approach did not increase the perioperative mortality and complication rates in Siewert type Ⅱ AEG,but obtained satisfactory length of the proximal surgical margin,and was better than left transthoracic approach in thoracic and abdominal lymph node dissection.However,the advantages of Ivor-Lewis procedure requires further follow-up and validation through prospective randomized controlled trials.

Objective: To compare the extent of lymphadenectomy and postoperative complications between Ivor-Lewis procedure and left sided thoracotomy in patients with Siewert type Ⅱ adenocarcinoma of the esophagogastric junction (AEG). Methods: The clinical data of 101 patients with Siewert type Ⅱ EG who received surgical treatment between January 2014 and September 2015 in the Department of Esophageal Cancer, Tianjin Medical University Cancer Hospital were analyzed retrospectively. These patients were divided into Ivor-Lewis group (IL, n=38) and left- sided thoracotomy group (LT, n=63) according to the operation mode. The number and extent of dissected lymph nodes and postoperative complications were compared between the two groups. Results: The surgical blood loss, length of postoperative stay, anastomotic leakage, pulmonary infection, respiratory failure and complications of incision of the two groups showed no significant differences (P>0.05 of all). The operation time of IL group was 200 min, significantly longer than the LT group (120 min, P<0.05). The number of resected lymph nodes in the IL and LT groups were (20±9) and (13±7), respectively, with a statistically significant difference (P<0.001). Significantly more thoracic lymph nodes (7±5) were harvested in the IL group than in the LT group (2±2, P<0.001), and the number of resected abdominal lymph nodes in the IL and LT groups were (13±8) and (11±7), with a non-significant difference (P=0.157). As regarding the lymph node dissection rate, the IL approach was obviously better than the LT approach in the following lymph node stations: superior mediastinal nodes, subcarinal nodes, left hilar nodes, right hilar nodes, middle thoracic paraesophageal nodes, lower thoracic paraesophageal nodes, lymph nodes along the common hepatic artery, and lymph nodes along the splenic artery(P<0.05 for all). Conclusions The Ivor-Lewis procedure achieves better thoracic and abdominal lymph node dissection, and does not cause more postoperative complications than the left-sided thoracotomy in patients with Siewert type Ⅱ AEG. However, these findings need to be confirmed by large-scale randomized clinical trial in the future.