Therapeutic Efficacy Comparison Of Two Surgical Approaches To Treat Middle Thoracic Esophageal Carcinoma

Objective:To compare and evaluate the therapeutic efficacy of two different surgical approaches to treat middle thoracic esophageal squamous cell carcinoma.Methods:One hundred and eighty-four patients with middle thoracic esophageal squamous cell carcinoma, including 132 who underwent Ivor-Lewis esophagectomy and another 52 who underwent one incision esophagectomy through left thoracic and upper arotic arch approach, were reviewed. The survival rate was calculated by Kaplan-Meier method and the prognostic risk factors were assessed by Cox regression analysis.Results: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 thoracic 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 thoracic 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.Conclusions:Ivor-Lewis esophagectomy and one incision esophagectomy through left thoracic and upper arotic arch approach are both feasible options to treat middle thoracic esophageal squmamous cell carcinoma. Patients'individual condition is suggested to be taken into account when choosing the operative approachs.