Short-term efficacy of minimally invasive esophagectomy combined with three-field versus two-field lymphadenectomy for 257 patients with esophageal squamous cell carcinoma:A retrospective cohort study
Objective To explore the safety of minimally invasive esophagectomy(MIE)with three-field lymphadenectomy(3-FL)for esophageal squamous cell carcinoma(ESCC)by comparing the short-term outcomes between the 3-FL and the two-field lymphadenectomy(2-FL)in MIE.Methods The clinical data of patients with ESCC who underwent minimally invasive McKeown esophagectomy in our hospital from July 2015 to March 2022 were collected retrospectively.Patients were divided into a 3-FL group and a 2-FL group according to lymph node dissection method.And the clinical outcomes and postoperative complications were compared between the two groups.Results A total of 257 patients with ESCC were included in this study.There were 211 males and 46 females with an average age of 62.2±8.1 years.There were 109 patients in the 3-FL group and 148 patients in the 2-FL group.The operation time of the 3-FL group was about 20 minutes longer than that of the 2-FL group(P＜0.001).There was no statistical difference between the two groups in the intraoperatve blood loss(P=0.376).More lymph nodes(P＜0.001)and also more positive lymph nodes(P=0.003)were obtained in the 3-FL group than in the 2-FL group,and there was a statistical difference in the pathological N stage between the two groups(P＜0.001).But there was no statistical difference in the incidence of anastomotic leak(P=0.667),chyle leak(P=0.421),recurrent laryngeal nerve injury(P=0.081),pulmonary complications(P=0.601),pneumonia(P=0.061),cardiac complications(P=0.383),overall complications(P=0.147)or Clavien-Dindo grading(P=0.152)between the two groups.Conclusion MIE 3-FL can improve the efficiency of lymph node dissection and the accuracy of tumor lymph node staging,but it does not increase the postoperative complications,which is worthy of clinical application.
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