Comparison of short‐term outcomes and three yearsurvival between total minimally invasiveMcKeown and dual‐incision esophagectomy

Abstract

BackgroundThe aim of this study was to compare the short‐term outcomes and three‐year survival between dual‐incision esophagectomy (DIE) and total minimally invasive McKeown esophagectomy (MIME) for esophageal cancer patients with negative upper mediastinal lymph nodes requiring esophagectomy and neck anastomosis.MethodsOne hundred and fifty patients underwent DIE, while 361 patients received total MIME. Perioperative outcomes and three‐year survival were compared in unmatched and propensity score matched data between two groups.ResultsBoth unmatched and matched analysis demonstrated that there were no significant differences in the number of lymph nodes harvested, or major or minor complication rates between the DIE and MIME groups. Compared with patients who underwent DIE, patients who underwent total MIME had longer operation duration (310 minutes vs. 345 minutes; P = 0.002). However, there was significantly less intraoperative blood loss in the total MIME compared with the DIE group (191 mL vs. 287 mL, respectively; P < 0.001). Kaplan‐Meier analysis demonstrated a trend that patients who underwent MIME had longer overall (79.5% vs. 64.1%; P = 0.063) and disease‐free three‐year survival (65.3% vs. 82.8%; P = 0.058) compared with patients who underwent DIE.ConclusionsBoth total MIME and DIE are feasible for the surgical treatment of esophageal cancer patients with negative upper mediastinal lymph nodes requiring esophagectomy and neck anastomosis. However, MIME was associated with better overall and disease‐free three‐year survival compared with DIE.

Value of the preoperative neutrophil‐to‐lymphocyte ratio as a prognostic factor for long‐term survival in postoperative esophageal squamous cell carcinoma patients

“…Nearly 50% of esophageal cancer cases and deaths resulting from esophageal cancer occur in China . Esophageal squamous cell carcinoma (ESCC) accounts for > 90% of all pathological types of esophageal cancer in China . Surgery is the main treatment for resectable esophageal cancer.…”

“…1,2 Esophageal squamous cell carcinoma (ESCC) accounts for > 90% of all pathological types of esophageal cancer in China. 3,4 Surgery is the main treatment for resectable esophageal cancer. In recent years, with the development of medical science, surgical methods for treating esophageal cancer have made great progress, but the prognosis of esophageal cancer is still poor.…”

Comparison of short‐term outcomes following minimally invasive versus open Sweet esophagectomy for Siewert type II adenocarcinoma of the esophagogastric junction

“…reported that the range of abdominal lymph node dissection for OSE was significantly lower than that for the abdominal‐transhiatal approach . Meanwhile, an increasing number of studies have reported that the range of lymph node dissection with the laparoscopic approach was comparable to open surgery . The results of this study show that the numbers and locations of dissected lymph nodes were better in the MISE group than those in the OSE group.…”

Society for Translational Medicine Expert consensus on the selection of surgical approaches in the management of thoracic esophageal carcinoma

“…Although it was a small study, no difference (43), performed a controlled randomized study comparing the short-term outcomes and 3-year survival between total MIE 3 stage McKeown and the so called dual-incision esophagectomy through an open left thoracotomy (DIE = Sweet procedure). They concluded that MIE and DIE yielded comparable short-term outcomes, however MIE was associated with better three year overall and disease-free survival (43). Moreover, Sun et al (44) performed an important control randomized study comparing two groups of patients operated by MIE 3 stage Mckeown esophagectomy.…”