Lymph node dissection for Siewert II esophagogastric junction adenocarcinoma: a retrospective study of 136 cases

ANZ Journal of Surgery
Xiaofeng DuanZhentao Yu

Abstract

To compare the lymph node dissection with the right transthoracic Ivor-Lewis (IL) procedure to that with the left transthoracic (LT) approach for Siewert type II adenocarcinoma of the esophagogastric (AEG) junction. In this study, 136 patients with Siewert type II AEG who met the inclusion criteria underwent surgical resection were divided into the IL (47 cases) and LT (89 cases) groups. The number and frequency of the dissected lymph nodes in each station were compared between the two groups. The IL group had a longer proximal surgical margin (P = 0.000) and more total (P = 0.000), thoracic (P = 0.000), and abdominal lymph nodes (P = 0.000) dissected than the LT group. In general, the IL group had a higher dissection rate in each thoracic lymph node station (P < 0.05) than the LT group. The dissection rates of the hepatic artery, splenic artery and celiac trunk lymph nodes were higher in the IL group than in the LT group (P < 0.05). The lymph node metastasis rate was 78.7% in the IL group, higher than the 61.8% in the LT group (P = 0.045). The right transthoracic IL procedure was demonstrated to be a better application than the LT approach for Siewert type II AEG in terms of the number and frequency of lymph node resections.

References

Nov 21, 1998·The British Journal of Surgery·J R Siewert, H J Stein
Jun 28, 2001·The Annals of Thoracic Surgery·A L VisbalP C Pairolero
Sep 21, 2006·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·M J ForshawR C Mason
Nov 27, 2010·The Lancet Oncology·Christophe MarietteJean Pierre Triboulet
Jul 21, 2011·Annals of Surgery·Hiroharu YamashitaTakeo Fukagawa
Aug 17, 2012·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Kazumasa FujitaniYuichiro Doki
Aug 15, 2013·Annals of Surgical Oncology·Shinichi HasegawaAkira Tsuburaya
Mar 25, 2014·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Hironobu GotoMasanori Terashima
May 20, 2015·The Annals of Thoracic Surgery·Jun PengLong-Qi Chen

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