Comparison Of Curative Effect Between Right Thoracic Approach Radical Esophagectomy And Left Thoracic Sweet Surgery

Objective: To compare the effects of radical esophagectomy for right thoracic approach with conventional left chest incision approach esophagectomy(Sweet surgery)for treatment cancer of mid�to�distal thoracic esophagus.Methods: The clinical data of 125 patients with mid-to-distal thoracic esophageal cancer who underwent radical esophagectomy for right thoracic approach from January 2010 to January 2015 were retrospectively analyzed.357 patients were served as control who underwent Sweet procedure in the same period.Results: There was no significant difference in survival between patients with right thoracic approach and left thoracic Sweet surgery.There was no significant difference in the number of lymph node dissections,the number of lymph node dissections in thoracic cavity,the number of lymph node dissections in abdominal cavity,and the perioperative mortality rate between the two groups.The average length of hospital stay after right thoracic approach surgery was longer than that of the Sweet group.The difference was statistically significant.The incidence of anastomotic leakage and pleural effusion was higher in the right thoracic group than in the Sweet group,and the difference was statistically significant;the incidence of respiratory failure,chylothorax,and poor incision healing was not statistically significant.The analysis of subgroups showed that the incidence of anastomotic leakage in the MIE group was higher than that in the Sweet group,and the difference was statistically significant;There was no significant difference in the incidence of chylothorax,pleural effusion,respiratory failure and poor incision healing.Conclusion: Compared with the Sweet surgery,the procedure in right thoracic approach did not show obvious advantages in lymph node dissection and long-term survival.However,the postoperative hospital stay is longer and postoperative complication rate is higher than those in the left thoracic Sweet group.Therefore,the Sweet procedure of esophagectomy is not inferior to the procedure through right thoracic approach in efficiency but is safer.