[A clinical study of thoracic-abdominal double-incision and two-field lymphadenectomy in treatment of esophagogastric junction cancer].
OBJECTIVE
To explore the best operation pattern of esophagogastric junction (EGJ) cancer and the regularity of lymph node metastasis in EGJ cancer according to Siewert typing.


METHODS
Twenty-six patients with EGJ cancer received esophagogastrectomy by thoracic-abdominal double incision and two-field lymphadenectomy (12 cases) or by traditional left postero-lateral thoracotomy and lymph node sampling (14 cases). The outcomes were analyzed with SPSS 10.0 software


RESULTS
(1) The number of lymph node dissection group of the thoracic-abdominal double incision group was 7.3 lymph node groups, significantly more than that of the traditional left postero-lateral thoracotomy group (3.5 lymph node group, P < 0.001). The number of proved metastatic lymph nodes of the thoracic-abdominal double incision group was 1.9 groups, significantly higher than that of the traditional left postero-lateral thoracotomy group (0.9 group, P = 0.013). The distance between the esophageal incisal edge and the tumor was 5.8 cm in the thoracic-abdominal double incision, longer than that in the traditional left thoracotomy group (5.1 cm). The diaphragm was not damaged in the double-incision group, thus the influence to respiration and circulation was decreased. (2) The abdominal metastasis of Siewert type I cancer was not severe, the cancer of type II might metastasize to abdominal or thoracic cavity, and the main metastatic site of type III cancer was abdominal cavity.


CONCLUSIONS
Thoracic-abdominal double incision and two-field lymphadenectomy helps increase the radical resection rate of EGJ cancer and study the regularity of lymph node metastasis.
Xiong
Hong-Chao
HC
Department of Thoracic Surgery, Peking University School of Omology, Beijing Cancer Hospita and Institutel, Beijing 100036, China.
Wu
Nan
N
Chen
Jin-Feng
JF
Zhang
Li-Jian
LJ
Ji
Jia-Fu
JF
Yang
Yue
Y
D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004943:Esophagogastric Junction; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome