OUTCOMES OF IVOR-LEWIS AND MINIMAL INVASIVE MCKEOWN ESOPHAGECTOMY FOR LOWER AND MIDDLE ESOPHAGEAL CANCER.

Background: Ivor-Lewis esophagectomy and Mckewon esophagectomy are used to treat esophageal cancer, and minimally invasive technique is increasingly adopted to lower morbidities and complications after operation. Surgical approaches to esophageal cancer are not standardized however. This study compares results of Mckeown esophagectomy as minimally invasive technique with the conventional Ivor-Lewis esophagectomy. Data of patients underwent Ivor-Lew Methods: is esophagectomy (ILE) or minimally invasive Mckeown esophagectomy (MIME) operation from January 2009 to December 2019 were retrospectively collected. Preoperative conditions, cancer characteristics, and operative outcomes were selected as variables for analysis. Total 125 patients undergone surgery for esophagus, 54 got ILE for esophageal cancer and 65 got MIME. Results: Despite minimally invasive approach, Mckeown esophagectomy tend to get more complications than Ivor-Lewis esophagectomy. Postoperative arrhythmias and vocal cord palsy occurred significantly higher in MIME group than ILE. Fatal complications like pneumonia, bronchoesophageal fistula, stenosis or leakage of anastomosis site also appeared more frequent in MIME group with low significance. Short term mortalities showed no difference. When comparing total survival and disease-free survival at middle to lower esophageal cancer, MIME group seemed better survival and lowerer cancer recurrence than ILE group, although significance was low. Surgical methods should be thoroughly consid Conclusions: ered in managing esophageal cancer due to possible postoperative morbidities. MIME tend to have higher postoperative complications than ILE, but short-term mortalities showed no differences. When managing middle and lower esophageal cancer MIME can be an option to lower cancer recurrence and better survival.