Short-term Efficacy Of Total Endoscopic Ivor-Lewis And McKeown Procedures In The Treatment Of Middle And Lower Esophageal Cancer

Object:To compare the short-term efficacy of total endoscopic Ivor-Lewis and McKeown in the treatment of middle and lower esophageal cancer.Method:A retrospective analysis was made of 129 patients who underwent minimally invasive radical esophagectomy in our hospital from January 2014 to April 2017.Among them,73 were in Ivor-Lewis group and 56 were in McKeown group.Sex,age,tumor location and pathological type,TNM stage after operation were compared between the two groups.The operation time,bleeding volume,number of lymph node dissection,indwelling time of drainage tube,hospitalization time,hospitalization cost,incidence of complications and recurrence rate of tumors at 6months after operation were compared between the two groups.Result:There was no significant difference in preoperative general data of sex,age and complications between the two groups(P>0.05);there were no significant differences in operation time,intraoperative bleeding volume,lymph node dissection,lymph node metastasis rate,drainage tube indwelling time,post-operative hospitalization time and hospitalization cost between the two groups(P>0.05);there was no significant difference in the incidence of total complications and the recurrence rate of tumors 6 months after operation(P>0.05).However,the incidence of anastomotic leakage,anastomotic stenosis and recurrent laryngeal nerve injury in Ivor-Lewis group was lower than that in McKeown group[2.7%(2/73)vs.16.1%(9/56),?~2=5.613,P=0.018;4.1%(3/73)vs.17.8%(10/56),?~2=6.620,P=0.010;4.1%(3/73)vs.19.6%(11/56),?~2=7.895,P=0.005].Conclusion:Total endoscopic Ivor-Lewis procedure and McKeown procedure are both safe and effective in the treatment of middle and lower esophageal cancer.However,Ivor-Lewis procedure has advantages over McKeown procedure in the control of some complications,and the short-term effect is satisfactory.