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Comparison and analysis of left thoracic incision and right thoracoabdominal incision in the radical surgery for middle and lower esophageal cancer
Pages: 531-533,558
Year: Issue:  5
Journal: Oncology Progress

Abstract: Objective To compare the curative effect of left thoracic incision (Sweet) and right thoracoabdominal in-cision (Ivor-Lewis) in the treatment of middle and lower esophageal cancer. Method 86 patients with middle and lower esophageal cancer who had undergone surgery were enrolled and divided into Sweet group (43 cases) and Ivor-Lewis group (43 cases) based on surgery modes;the operation time, retention time of thoracic drainage tubes, number of lymph nodes harvested, length of hospital stay, positive rate of esophagus upper resection margin, and the incidence of postopera-tive complications were compared between two groups. Result The operation time and the number of lymph nodes har-vested in Sweet group were significantly lower than those in Ivor-Lewis group (P<0.01), and there were no significant dif-ferences found in the length of hospital stay and the retention time of thoracic drainage tubes between two groups (P>0.05). The positive resection margins were mainly resection margins of middle and lower part of esophagus in Sweet group and of middle part of esophagus in Ivor-Lewis group, and the differences reached statistical significance (P<0.05). Complications of surgical site infection, anastomotic fistula, empyema, chylothorax, pulmonary infection and anastomotic bleeding were reported in the two groups, the overall incidence of these events in Sweet group (23.26%) was higher than that in Ivor-Lewis group (18.60%), but the difference was not statistically significant (χ2=0.281, P>0.05). Conclusion In the treatment of middle and lower esophageal cancer, the left thoracic incision has the advantage of short operation time and small invasive scope, while right thoracoabdominal incision provides a good visual field for the surgery and a thorough clearance of lymph nodes. The specific surgical method should be chosen according to the actual condition of the patients.
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