Thoracic laparoscopy in the left thoracic and epigastric approach versus left thoracic approach in the treatment of Siewert type Ⅱ adenocarcinoma of the esophagogastric junction
Objective To explore the efficacy of thoracic laparoscopy in the left thoracic and epigastric approach versus left thoracic approach in the treatment of Siewert type Ⅱ adenocarcinoma of the esophagogastric junction(AEG).Methods Clinicopathological data of 109 patients with Siewert type Ⅱ AEG who underwent radical resection in Handan Central Hospital between June 2019 and December 2022 were retrospectively analyzed.According to the surgical method,patients were divided into the left thoracic and epigastric approach group and left thoracic approach group.The operation time,blood loss,length of proximal resection margin,number of removed lymph nodes,length of stay,postoperative complications,survival and quality of life were compared between the two groups.Results The length of tumor margins in the left thoracic and epigastric approach group was significantly shorter than that of the left thoracic approach group(P＜0.05),and the other data like age,sex and tumor staging were comparable(P＞0.05).Patients in the left thoracic and epigastric approach group had significantly longer operation time,less intraoperative bleeding,shorter length of stay and greater number of removed lymph nodes than those of the left thoracic approach group(all P＜0.05).There was no significant difference in the postoperative complication rate between the left thoracic and epigastric approach group and the left thoracic approach group(18.03%vs 14.58%,P＞0.05).Physical function,emotional function,and overall health at 1 week and 3 weeks postoperatively were significantly better in the left thoracic and epigastric approach group than those of the left thoracic approach group(P＜0.05).The 1-year and 2-year survival were significantly higher in the left thoracic and epigastric approach group than those of the left thoracic approach group(P＜0.05).Conclusion Thoracic laparoscopy in the left thoracic and epigastric approach has higher safety and better short-term efficacy on patients with Siewert type Ⅱ AEG than the left thoracic approach,especially in thoracic and abdominal lymph node dissection.
Siewert type Ⅱadenocarcinoma of the esophagogastric junctionthoracic laparoscopy
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