Yu Fan, Zhang Yaozhong, Xu Haidi, Li Kuankuan, Gheng Jingge, Lin Chenxi, Li Lei, Wang Na, Wang Lei
Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Department of infectious disease, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Front Oncol. 2022 Dec 19;12:1009315. doi: 10.3389/fonc.2022.1009315. eCollection 2022.
There are two most widely used transthoracic esophagectomy methods: the McKeown Minimally Invasive esophagectomy (McKeown MIE) and the Sweet Esophagectomy. We evaluated and compared the therapeutic effects of these two methods to determine the appropriate method for the treatment of middle and lower third esophageal cancer patients who received neoadjuvant chemotherapy combined with immunotherapy (NACI). We retrospectively analyzed 43 sweet esophagectomy cases received NACI and 167 cases with McKeown MIE in the fourth hospital of Hebei Medical University from December 2019 to May 2022. This retrospective observational study showed that Sweet esophagectomy and McKeown MIE after NACI therapy for resectable ESCC patients appeared to be safe with low operative mortality and morbidity rate in the current population. In addition, sweet esophagectomy was associated with a lower incidence of severe complications and shorter hospital stay for patients over 70 years of age compared with McKeown MIE. There were no differences were found in length of stay, mortality and complication incidence rate between the two groups. The Sweet approach has advantage in hospital stay for the treatment of the elderly NACI patients with middle or lower third esophageal squamous cell carcinoma. In conclusion, Sweet esophagectomy and McKeown MIE are both safe, effective, and worthwhile approaches for ESCC patients in immunotherapy age.
麦克尤恩微创食管癌切除术（McKeown MIE）和斯威特食管癌切除术。我们评估并比较了这两种方法的治疗效果，以确定适合接受新辅助化疗联合免疫治疗（NACI）的中下段食管癌患者的治疗方法。我们回顾性分析了河北医科大学第四医院2019年12月至2022年5月期间接受NACI的43例斯威特食管癌切除术病例和167例McKeown MIE病例。这项回顾性观察研究表明，对于可切除的食管鳞癌患者，NACI治疗后行斯威特食管癌切除术和McKeown MIE在当前人群中似乎是安全的，手术死亡率和发病率较低。此外，与McKeown MIE相比，斯威特食管癌切除术在70岁以上患者中严重并发症发生率较低，住院时间较短。两组在住院时间、死亡率和并发症发生率方面没有差异。斯威特术式在治疗老年NACI中下段食管鳞状细胞癌患者的住院时间方面具有优势。总之，对于免疫治疗时代的食管鳞癌患者，斯威特食管癌切除术和McKeown MIE都是安全、有效且值得采用的方法。
