Kumar Naveen, Mandal Amitabha, Bhoriwal Sandeep, Deo S V S, Bharati Sachidanand Jee, Kumar Sunil
Department of Surgical Oncology, DR BRAIRCH, Room-244, All India Institute of Medical Sciences, New Delhi, 110029 India.
Department of Onco-Anaesthesia, DR BRAIRCH, All India Institute of Medical Sciences, New Delhi, India.
Indian J Surg Oncol. 2025 Apr;16(2):465-471. doi: 10.1007/s13193-023-01770-4. Epub 2023 May 25.
The commonly performed surgical procedures for esophageal cancer are McKeown and Ivor Lewis esophagectomy. The Ivor Lewis esophagectomy is mainly performed for lower esophageal cancer. Herein, we analyzed both procedures performed for lower esophageal cancer to look for perioperative and survival outcomes. The surgical data was retrieved from the computerized database, and the patients operated on for lower esophageal cancer from 2014 to 2019 were included. Both procedures were analyzed for demographic details, perioperative outcomes, complication rate, and overall and disease-free survivals. A total of 90 patients undergoing esophagectomy for lower esophageal cancer. RLN palsy and anastomotic leak rate were higher in the McKeown group. The estimated 5-year OS was 49% and 58.3% in the McKeown and Ivor Lewis groups, respectively, whereas the estimated 5-year DFS was 41% and 63.9%. In the Ivor Lewis group, on comparing both histological subtypes, the estimated 5-year OS was 74% and 26.3% ( < 0.05) whereas the DFS was 74.5% and 42% ( = 0.07) for SCC and adenocarcinoma, respectively. This study did not find a significant difference in the perioperative as well as survival outcomes comparing McKeown esophagectomy with the Ivor Lewis procedure for lower third esophageal cancer. A prospective trial is warranted to see the difference.
食管癌常见的手术方式是麦克尤恩（McKeown）食管切除术和艾弗·刘易斯（Ivor Lewis）食管切除术。艾弗·刘易斯食管切除术主要用于治疗下段食管癌。在此，我们分析了这两种用于治疗下段食管癌的手术方式，以探寻围手术期和生存结果。手术数据从计算机数据库中获取，纳入了2014年至2019年接受下段食管癌手术的患者。对这两种手术方式的人口统计学细节、围手术期结果、并发症发生率以及总生存率和无病生存率进行了分析。共有90例患者接受了下段食管癌食管切除术。麦克尤恩组的喉返神经麻痹和吻合口漏发生率较高。麦克尤恩组和艾弗·刘易斯组的估计5年总生存率分别为49%和58.3%，而估计5年无病生存率分别为41%和63.9%。在艾弗·刘易斯组中，比较两种组织学亚型，鳞状细胞癌和腺癌的估计5年总生存率分别为74%和26.3%（<0.05），而无病生存率分别为74.5%和42%（=0.07）。本研究未发现麦克尤恩食管切除术与艾弗·刘易斯手术治疗食管下段癌在围手术期和生存结果上有显著差异。有必要进行一项前瞻性试验来观察差异。
