Comparsion of Clinical Outcomes between Minimally Invasive Esophagectomy McKeown and Ivor-Lewis for Lower Thoracic Esophageal Cancer

XIA Wenqiang; LI Ning; LU Chaojing

doi:10.15926/j.cnki.issn2096-7381.2025.03.005

Abstract：Objective To compare the clinical outcomes of minimally invasive esophagectomy(MIE)Ivor-Lewis and Mckeown for lower thoracic esophageal cancer.Methods Clinical data of 482 patients with lower thoracic esophageal cancer admitted to the First Affiliated Hospital of Naval Medical University from June 2015 to December 2020 were retrospectively analyzed and divided into MIE Ivor-Lewis and MIE Mckeown groups.234 patients in MIE Mckeown group underwent radical resection through three incisions of left neck,right chest,and abdomen with the combination of thoracoscopy and laparoscopy.248 patients in MIE Ivor-Lewis group underwent radical resection of esophageal cancer through thoracic and abdominal incision.A total of 233 patients were included after propensity score-matching procedure according to the baseline char-acteristics.The operative,perioperative and long-term follow-up data of the two groups were compared.Results The mean number of lymph nodes dissection in MIE Mckeown group was(26.1±9.7),significantly higher than that in MIE Ivor-Lewis group(23.3±7.9,P<0.001).17 patients(7.29%)in MIE Mckeown group had perioperative anastomotic leakage,significantly higher than that of MIE Ivor-Lewis group(0.86%)(P<0.001).The incidence of perioperative hoarseness in MIE Mckeown group was 9.01%,significantly higher than that in MIE Ivor-Lewis group(4.29%)(P=0.041).The 5-year survival rates of MIE Mckeown group(50.9±6.9)%were lower than that of MIE Ivor-Lewis group(59.5±3.5)%,but the difference was not statistically significant(P=0.153 7).Conclusion MIE Ivor-Lewis and MIE Mckeown have comparable clinical effects in the treatment of lower thoracic esophageal cancer,but MIE Ivor-Lewis may be an ideal choice for lower thoracic esophageal cancer for its lower perioperative complications.