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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2023

03-08-2023 | Esophageal Cancer | Thoracic Oncology

Efficacy and Quality of Life with the Modified Versus the Traditional Thoraco-Laparoscopic McKeown Procedure for Esophageal Cancer: A Multicenter Propensity Score-Matched Study

Authors: Ziqiang Hong, MD, Baiqiang Cui, MD, Yingjie Lu, MD, Xiangdou Bai, MD, Ning Yang, MD, Xiaoyang He, MD, Xusheng Wu, MD, Tao Cheng, MD, Dacheng Jin, MD, Jing Zhao, MD, Yunjiu Gou, MD

Published in: Annals of Surgical Oncology | Issue 13/2023

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Abstract

Background

This study aimed to compare the efficacy and postoperative quality of life for patients with esophageal cancer treated by either the modified or the traditional thoracolaparoscopic McKeown procedure.

Methods

This retrospective case-control study included 269 patients with esophageal cancer admitted to three medical centers in China from February 2020 to August 2022. The patients were divided according to surgical method into the layered hand-sewn end-to-end invagination anastomosis group (modified group) and the traditional hand anastomosis group (traditional group). Propensity score-matching (PSM) was used to maintain balance and comparability between the two groups.

Results

The differences in age and tumor location between the patients in the traditional and modified groups were statistically significant. After PSM, the aforementioned factors were statistically insignificant. After PSM, each group had 101 patients. The modified group showed the greater advantage in terms of postoperative hospital stay (P = 0.036), incidence of anastomotic leak (P = 0.009), and incidence of gastroesophageal reflux (P < 0.001), and the difference was statistically significant. The results of the Quality of Life Questionnaire Core 30 (QLQ-C30) and Quality of Life Questionnaire Oesophageal Cancer Module 18 (QLQ-OES18) scales showed that the modified group also had the advantage over the traditional group in terms of physical function, overall health status, loss of appetite, eating, reflux, obstruction, and loss of appetite scores at the first and third months after surgery.

Conclusion

The modified thoraco-laparoscopic McKeown procedure is a safe and effective surgical approach that can significantly reduce the incidence of postoperative anastomotic leak and gastroesophageal reflux, shorten the postoperative hospital stay, and improve the postoperative quality of life for patients with esophageal cancer.
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Metadata
Title
Efficacy and Quality of Life with the Modified Versus the Traditional Thoraco-Laparoscopic McKeown Procedure for Esophageal Cancer: A Multicenter Propensity Score-Matched Study
Authors
Ziqiang Hong, MD
Baiqiang Cui, MD
Yingjie Lu, MD
Xiangdou Bai, MD
Ning Yang, MD
Xiaoyang He, MD
Xusheng Wu, MD
Tao Cheng, MD
Dacheng Jin, MD
Jing Zhao, MD
Yunjiu Gou, MD
Publication date
03-08-2023
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 13/2023
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-023-14033-x

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