Abstract: Objective To investigate the efficacy of the Ivor Lewis cervical stapled esophagogastrostomy via thorax in the treatment of middle esophageal carcinoma.
Methods The clinical data of 303 patients with middle esophageal carcinoma who were admitted to the Rugao Boai Hospital (107 patients) and the Rugao People′s Hospital (196 patients) from March 2005 to March 2013 were prospectively analyzed. All the patients received Ivor Lewis stapled cervical esophagogastrectomy (Ivor Lewis group, 151 patients) or Sweet stapled cervical esophagogastrostomy (Sweet group, 152 patients) according to the admission order. The intraoperative condition, peri operative complications, lymph node dissection and postoperative follow up of the 2 groups were analyzed. All the patients were followed up via out patient examination till December 2012. The measurement data, enumeration data and the ranked data were analyzed using the independent samples t test, chi square test or Fisher exact pro bability and Wilcoxon rank sum test, respectively. The survival curve was drawn by the Kaplan Meier method, and the postoperative mortality rate was analyzed using the Cox proportional hazard model.
Results The operation time of the Ivor Lewis group was (239±21)minutes, which was significantly longer than (188±30)minutes of the Sweet group ( t=11.32, P =4.65, 11.73, 7.97, P <0.05).
Conclusion Ivor Lewis stapled cervical esophagogastrostomy via thorax has advantages of high resection rate, better safety and better quality of life of patients, and it could be an optimized design of the treatment for patients with middle esophageal cancer without intumescent lymph node of neck.