Comparison Of 2.5-field With 3-field Lymphadenectomy In Minimally Invasive Esophagectomy For Esophageal Squamous Cell Carcinoma

Background:There are several kind of lymphadenectomy for esophageael squamous cell carcinoma(ESCC).Our previous studies reported that the mesoesophageal suspension technique and 2.5 field lymph node dissection is safe and effective,which meant we did the lymphadenectomy of 101 group through thoracic approach,but a direct comparison with the 3-field lymph node dissection is lacking.In this study,we try to compare the2.5-and 3-field lymph node dissections on occurrence of complications,recurrence patterns and the survival benefits in patients with ESCC.Method:We retrospectively reviewed the patients with thoracic ESCC treated in our hospital between January 2015 and December 2016.All of the patients underwent 2.5-or 3-field lymph node dissection(2.5-field group and 3-field group).The two groups were matched with propensity score matching method(PSM).We compared the outcomes between two groups,including postoperative complications rates,re-operation rates,30-day mortality,disease-free survival(DFS),recurrence pattern and overall survival(OS).We used SPSS22.0 software to perform statistical analysis on the data of two groups,and A p-value of <0.05 was considered statistically significant for all procedures.Result:A total of 146 patients were included in this study,including 86 patients in the 2.5field group and 60 patients in the 3-field group.Compared with the 3-field group,2.5-field group showed less number of dissected lymph nodes and comparable number of metastatic lymph nodes.The frequency of all postoperative complications(33.3% vs.14.3%,P=0.040)and postoperative respiratory complications(23.8% vs.7.1%,P=0.035)was higher in 3-field group.There were no differences in the recurrence patterns when considering all patients(P>0.05).Two groups showed similar OS and DFS,no matter before or after PSM.Conclusion:According to our results,2.5-and 3-field lymph node dissections have comparable regional recurrence and survival benefits,while the 2.5-field lymph node dissection associated with lower risk of postoperative complications.