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.	陈克能. 食管癌手术入路的百年演变及临床意义[J]. 中华胃肠外科杂志, 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, 董静思, 等. 胸段食管癌左右胸入路清扫淋巴结的结果比较[J]. 中华肿瘤杂志, 2012, 34(4): 296-300.
4.	罗孔嘉, 傅剑华, 胡祎, 等. 左右胸两种入路治疗胸中段食管鳞癌的手术评价[J]. 癌症, 2009, 28(12): 1260-1264.
5.	侯建彬, 宋清荣, 周福有, 等. 手术入路对胸段食管癌pN分期的影响[J]. 中华胃肠外科杂志, 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.	陈钢, 王洲, 刘相燕, 等. 胸中段食管鳞癌Ivor-Lewis手术后肿瘤复发196例临床分析[J]. 癌症, 2006, 25(1): 96-99.
9.	李进东, 王文光, 许金良, 等. 胸段食管癌淋巴结转移特点的研究[J]. 中华医学杂志, 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.	柳硕岩, 朱坤寿, 郑庆丰, 等. 三野与二野淋巴结清扫对胸段食管鳞癌患者术后生存的影响[J]. 中华胸心血管外科杂志, 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.	张亚伟, 胡鸿, 缪珑升, 等. 胸中段食管癌淋巴结二野清扫术和三野清扫术的比较[J]. 中国癌症杂志, 2008, 18(7): 537-541.

1. 陈克能. 食管癌手术入路的百年演变及临床意义[J]. 中华胃肠外科杂志, 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, 董静思, 等. 胸段食管癌左右胸入路清扫淋巴结的结果比较[J]. 中华肿瘤杂志, 2012, 34(4): 296-300.
4. 罗孔嘉, 傅剑华, 胡祎, 等. 左右胸两种入路治疗胸中段食管鳞癌的手术评价[J]. 癌症, 2009, 28(12): 1260-1264.
5. 侯建彬, 宋清荣, 周福有, 等. 手术入路对胸段食管癌pN分期的影响[J]. 中华胃肠外科杂志, 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. 陈钢, 王洲, 刘相燕, 等. 胸中段食管鳞癌Ivor-Lewis手术后肿瘤复发196例临床分析[J]. 癌症, 2006, 25(1): 96-99.
9. 李进东, 王文光, 许金良, 等. 胸段食管癌淋巴结转移特点的研究[J]. 中华医学杂志, 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. 柳硕岩, 朱坤寿, 郑庆丰, 等. 三野与二野淋巴结清扫对胸段食管鳞癌患者术后生存的影响[J]. 中华胸心血管外科杂志, 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. 张亚伟, 胡鸿, 缪珑升, 等. 胸中段食管癌淋巴结二野清扫术和三野清扫术的比较[J]. 中国癌症杂志, 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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