Comparison of postoperative complications between different operation methods for esophageal cancer

Abstract

Background We explored the selection of surgical method and differences in postoperative complications in patients with esophageal cancer (EC). Methods The data of 434 patients with EC who underwent thoracic surgery at the Jiangsu Provincial People's Hospital between January 2011 and December 2016 were collected. Patients were divided into three groups: Sweet surgery (143 cases), Ivor–Lewis surgery (232 cases), and minimally invasive esophagectomy (MIE, 59 cases). The number of postoperative days, number of lymph nodes dissected, and incidence of pulmonary infection, serous membrane fluid, arrhythmia, chylous fistula, gastric emptying dysfunction, and anastomotic leakage were recorded. Results A statistically significant number of female stage I patients with upper EC underwent MIE (P < 0.05). Postoperative complications were observed in all three groups but were not statistically significant (P > 0.05). A greater number of lymph nodes were dissected in the Ivor–Lewis group compared to the other groups (P < 0.05). Conclusion Clinically, MIE is often selectively used for women with upper and mid‐early EC, especially in stage I. In our sample, more lymph nodes were dissected in the Ivor–Lewis than in the MIE group, which can reduce recurrence and improve the survival rate. Ivor–Lewis surgery is often used in mid‐lower and terminal EC, while MIE is often used in upper and mid‐early EC. Compared to the other surgical methods, MIE does not increase the risk of postoperative complications. The gradual maturation of MIE technology will further expand indications and increase the number of lymph nodes dissected.

Development and Validation of a New Integrative Score Based on Various Systemic Inflammatory and Nutritional Indicators in Predicting Prognosis in Patients With Resectable Esophageal Squamous Cell Carcinoma: A Retrospective Cohort Study

“…A study including 434 ESCC patients who underwent radical resection revealed that complication had no effect on long-term survival, despite an increasing immediate postoperative outcome and hospital mortality. 46 Another research including 1100 EC patients with resection indicated that AL did not adversely affect survival (the incidences of AL was 9.6%). 47 While another study indicated an opposite result.…”

Diaphragmatic dysfunction is associated with postoperative pulmonary complications in the aged patients underwent radical resection of esophageal cancer: a prospective observational study

“…The radical resection of esophageal cancer is primarily categorized into three surgical methods based on the tumor’s location: Ivor Lewis (via right thoracic and abdominal approach), McKeown (via the abdomen and left neck approach), and Sweet (via left thoracic approach). Ding et al have suggested that the incidence of PPCs is similar among those three methods ( 17 ). We did not choose to include only patients who underwent Ivor Lewis or McKeown surgery, but excluded the Sweet procedure from our study to mitigate potential interference caused by direct damage to the diaphragm associated with this method.…”

Impact of pulmonary infection after radical esophagectomy on serum inflammatory markers, pulmonary function indices, and prognosis

“… 20 Second, resection of the pulmonary vagal branch had little effect on lung function during the surgical procedure, particularly in patients with airway hyperresponsiveness, which may facilitate improvement and recovery of postoperative pulmonary function. 21 , 22 Third, the drug used for intraoperative anesthesia could have affected the pulmonary function. The anesthetic regimen of propofol + dexmedetomidine showed less damage than sevoflurane.…”