Safety Evaluation and Lymph Node Dissection Effect of Ivor-Lewis Esophagectomy for Patients with Esophageal Cancer_West China Medical Journal

Authors：

 TangXiaojun , WangXiaoyong , LiuGaohua

Department of Thoraco-cardiac Surgery, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;

Corresponding?author：

Keywords：

Esophageal cancer; Ivor-Lewis procedure; Complication; Lymph node dissection

DOI：

10.7507/1002-0179.201600181

Video：

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Objective To evaluate the safety and advantage in lymph node dissection of Ivor-Lewis esophagectomy in patients with esophageal cancer. Methods Clinical and pathological data of 78 patients with esophageal cancer who underwent Ivor-Lewis esophagectomy between September 2012 and March 2014 were collected and analyzed. Another 86 esophageal cancer patients who underwent esophagectomy of Sweet procedure during the same period were regarded as the controls. Duration of surgery, intra-operative blood loss, incidence of main complications and positive rate of lymph node were compared between the two groups. Results The duration of surgery in Ivor-Lewis group [(254.5±38.4) minutes] was longer than that in the Sweet group [(216.7±31.3) minutes]; and the average intra-operative blood loss in Ivor-Lewis group [(165.5±40.3) mL] was higher than that in the Sweet group [(148.7±35.4) mL]; the differences were significant (P < 0.01). Incidence of hoarseness in Ivor-Lewis group was significantly higher than that in Sweet group (P < 0.05), while incidences of other comp lications between the two groups were similar (P > 0.05). The proportion of patients with positive lymph nodes in Ivor-Lewis group (60.3%, 47/78) was significantly higher than that in Sweet group (26.7%, 23/86) (P < 0.05). Average number of lymph nodes dissected in Ivor-Lewis group (21.5±5.3) was significantly higher than that in Sweet group (10.6±4.1). Lymph nodes along the right recurrent laryngeal nerve was the most common metastasis in patients of Ivor-Lewis group, while lymph nodes in that area in Sweet group patients could hardly be dissected. Conclusions Ivor-Lewis esophagectomy is a safe surgical procedure for esophageal cancer. Ivor-Lewis procedure has more advantages in lymph node dissection than Sweet procedure.

Citation： TangXiaojun, WangXiaoyong, LiuGaohua. Safety Evaluation and Lymph Node Dissection Effect of Ivor-Lewis Esophagectomy for Patients with Esophageal Cancer. West China Medical Journal, 2016, 31(4): 659-662. doi: 10.7507/1002-0179.201600181 Copy

1.	?陳克能. 食管癌手術入路的百年演變及臨床意義[J]. 中華胃腸外科雜志, 2012, 15(9): 886-888.
2.	Nichols FC, Allen MS, Deschamps C, et al. Ivor lewis esophagogastrectomy[J]. Surg Clin North Am, 2005, 85(3): 583-592.
3.	毛友生, 赫捷, 董靜思, 等. 胸段食管癌左右胸入路清掃淋巴結的結果比較[J]. 中華腫瘤雜志, 2012, 34(4): 296-300.
4.	羅孔嘉, 傅劍華, 胡祎, 等. 左右胸兩種入路治療胸中段食管鱗癌的手術評價[J]. 癌癥, 2009, 28(12): 1260-1264.
5.	侯建彬, 宋清榮, 周福有, 等. 手術入路對胸段食管癌pN分期的影響[J]. 中華胃腸外科雜志, 2011, 14(7): 549-550.
6.	Fujita H. History of lymphadenectomy for esophageal cancer and the future prospects for esophageal cancer surgery[J]. Surg Today, 2015, 45(2): 140-149.
7.	Osugi H, Takemura M, Higashino M, et al. Causes of death and pattern of recurrence after esophagectomy and extended lymphadenectomy for squamous cell carcinoma of the thoracic esophagus[J]. Oncol Rep, 2002, 10(1): 81-87.
8.	陳鋼, 王洲, 劉相燕, 等. 胸中段食管鱗癌Ivor-Lewis手術后腫瘤復發196例臨床分析[J]. 癌癥, 2006, 25(1): 96-99.
9.	李進東, 王文光, 許金良, 等. 胸段食管癌淋巴結轉移特點的研究[J]. 中華醫學雜志, 2006, 86(45): 3197-3200.
10.	Igaki H, Kato H, Tachimori Y, et al. Prognostic evaluation of patients with clinical T1 and T2 squamous cell carcinomas of the thoracic esophagus after 3-field lymph node dissection[J]. Surgery, 2003, 133(4): 368-374.
11.	Tsurumaru M, Kajiyama Y, Udagawa H, et al. Outcomes of extended lymph node dissection for squamous cell carcinoma of the thoracic esophagus[J]. Ann Thorac Cardiovasc Surg, 2001, 7(6): 325-329.
12.	柳碩巖, 朱坤壽, 鄭慶豐, 等. 三野與二野淋巴結清掃對胸段食管鱗癌患者術后生存的影響[J]. 中華胸心血管外科雜志, 2014, 30(11): 645-648.
13.	Ye T, Sun YH, Zhang YL, et al. Three-field or two-field resection for thoracic esophageal cancer: a Meta-analysis[J]. Ann Thorac Surg, 2013, 96(6): 1933-1941.
14.	Akiyama H, Tsurumaru M, Udagawa H, et al. Radical lymph node dissection for cancer of the thoracic esophagus[J]. Ann Surg, 1994, 220(3): 364-373.
15.	張亞偉, 胡鴻, 繆瓏升, 等. 胸中段食管癌淋巴結二野清掃術和三野清掃術的比較[J]. 中國癌癥雜志, 2008, 18(7): 537-541.

1. ?陳克能. 食管癌手術入路的百年演變及臨床意義[J]. 中華胃腸外科雜志, 2012, 15(9): 886-888.
2. Nichols FC, Allen MS, Deschamps C, et al. Ivor lewis esophagogastrectomy[J]. Surg Clin North Am, 2005, 85(3): 583-592.
3. 毛友生, 赫捷, 董靜思, 等. 胸段食管癌左右胸入路清掃淋巴結的結果比較[J]. 中華腫瘤雜志, 2012, 34(4): 296-300.
4. 羅孔嘉, 傅劍華, 胡祎, 等. 左右胸兩種入路治療胸中段食管鱗癌的手術評價[J]. 癌癥, 2009, 28(12): 1260-1264.
5. 侯建彬, 宋清榮, 周福有, 等. 手術入路對胸段食管癌pN分期的影響[J]. 中華胃腸外科雜志, 2011, 14(7): 549-550.
6. Fujita H. History of lymphadenectomy for esophageal cancer and the future prospects for esophageal cancer surgery[J]. Surg Today, 2015, 45(2): 140-149.
7. Osugi H, Takemura M, Higashino M, et al. Causes of death and pattern of recurrence after esophagectomy and extended lymphadenectomy for squamous cell carcinoma of the thoracic esophagus[J]. Oncol Rep, 2002, 10(1): 81-87.
8. 陳鋼, 王洲, 劉相燕, 等. 胸中段食管鱗癌Ivor-Lewis手術后腫瘤復發196例臨床分析[J]. 癌癥, 2006, 25(1): 96-99.
9. 李進東, 王文光, 許金良, 等. 胸段食管癌淋巴結轉移特點的研究[J]. 中華醫學雜志, 2006, 86(45): 3197-3200.
10. Igaki H, Kato H, Tachimori Y, et al. Prognostic evaluation of patients with clinical T1 and T2 squamous cell carcinomas of the thoracic esophagus after 3-field lymph node dissection[J]. Surgery, 2003, 133(4): 368-374.
11. Tsurumaru M, Kajiyama Y, Udagawa H, et al. Outcomes of extended lymph node dissection for squamous cell carcinoma of the thoracic esophagus[J]. Ann Thorac Cardiovasc Surg, 2001, 7(6): 325-329.
12. 柳碩巖, 朱坤壽, 鄭慶豐, 等. 三野與二野淋巴結清掃對胸段食管鱗癌患者術后生存的影響[J]. 中華胸心血管外科雜志, 2014, 30(11): 645-648.
13. Ye T, Sun YH, Zhang YL, et al. Three-field or two-field resection for thoracic esophageal cancer: a Meta-analysis[J]. Ann Thorac Surg, 2013, 96(6): 1933-1941.
14. Akiyama H, Tsurumaru M, Udagawa H, et al. Radical lymph node dissection for cancer of the thoracic esophagus[J]. Ann Surg, 1994, 220(3): 364-373.
15. 張亞偉, 胡鴻, 繆瓏升, 等. 胸中段食管癌淋巴結二野清掃術和三野清掃術的比較[J]. 中國癌癥雜志, 2008, 18(7): 537-541.

West China Medical Journal

Safety Evaluation and Lymph Node Dissection Effect of Ivor-Lewis Esophagectomy for Patients with Esophageal Cancer

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