Curative Effect Comparision Between Ivor-Lewis Esophagectomy and Left Transthoracic Esophagectomy in Treatment of Middle Thoracic Esophagus Carcinoma

Abstract

The aim of this study is to compare and evaluate the therapeutic efficacy of Ivor-Lewis esophagectomy and one incision esophagectomy through left thoracic and above aortic arch anastomosis approach (left transthoracic esophagectomy) in order to choose a proper surgical procedure to treat middle esophageal carcinoma. Patients who underwent Ivor-Lewis esophagectomy (n=132) and who underwent left transthoracic esophagectomy (n=52) between January 2003 and June 2005 were included. The survival rate was calculated by Kaplan-Meier method and the prognostic risk factors were assessed by Cox regression analysis. Postoperative complications occurred in 43 patients (23.4%), with 31 patients (23.5%) and 12 patients (23.1%) in the Ivor-Lewis group and in the left transthoracic esophagectomy group, respectively. The overall 5-year survival rate was 36.4%, with 37.1% and 34.6% in the Ivor-Lewis group and in the left transthoracic esophagectomy group, respectively (p>0.05). In Cox regression analysis, T classification (HR=1.43, p=0.025) and N classification (HR=1.76, p=0.004) were the independent prognostic risk factors. Ivor-Lewis esophagectomy and left transthoracic esophagectomy are both feasible options to treat middle thoracic esophageal squamous cell carcinoma. Patients' individual condition is suggested to be taken into account when choosing the operative approach.