title: Lymph node dissection in esophageal carcinoma: Minimally invasive esophagectomy vs open surgery.
abstract: OBJECTIVE
  To compare lymph node dissection results of minimally invasive esophagectomy (MIE) and open surgery for esophageal squamous cell carcinoma.
  
  
  METHODS
  We retrospectively reviewed data from patients who underwent MIE or open surgery for esophageal squamous cell carcinoma from January 2011 to September 2014. Number of lymph nodes resected, positive lymph node (pN+) rate, lymph node sampling (LNS) rate and lymph node metastatic (LNM) rate were evaluated.
  
  
  RESULTS
  Among 447 patients included, 123 underwent MIE and 324 underwent open surgery. The number of lymph nodes resected did not significantly differ between the MIE and open surgery groups (21.1 ± 4.3 vs 20.4 ± 3.8, respectively, P = 0.0944). The pN+ rate of stage T3 esophageal squamous cell carcinoma in the open surgery group was higher than that in the MIE group (16.3% vs 11.4%, P = 0.031), but no differences was observed for stages T1 and T2 esophageal squamous cell carcinoma. The LNS rate at left para-recurrent laryngeal nerve (RLN) site was significantly higher for open surgery than for MIE (80.2% vs 43.9%, P < 0.001), but no differences were noted at other sites. The LNM rate at left para-RLN site in the open surgery group was significantly higher than that in the MIE group, regardless of pathologic T stage.
  
  
  CONCLUSIONS
  For stages T1 and T2 esophageal squamous cell carcinoma, the lymph node dissection result after MIE was comparable to that achieved by open surgery. However, the efficacy of MIE in lymphadenectomy for stage T3 esophageal squamous cell carcinoma, particularly at left para-RLN site, remains to be improved.
authors.affiliation: Bo Ye, Chen-Xi Zhong, Yu Yang, Wen-Tao Fang, Teng Mao, Chun-Yu Ji, Zhi-Gang Li, Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Ye
authors.affiliation: Bo Ye, Chen-Xi Zhong, Yu Yang, Wen-Tao Fang, Teng Mao, Chun-Yu Ji, Zhi-Gang Li, Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
authors.forename: Chen-Xi
authors.initials: CX
authors.lastname: Zhong
authors.affiliation: Bo Ye, Chen-Xi Zhong, Yu Yang, Wen-Tao Fang, Teng Mao, Chun-Yu Ji, Zhi-Gang Li, Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Bo Ye, Chen-Xi Zhong, Yu Yang, Wen-Tao Fang, Teng Mao, Chun-Yu Ji, Zhi-Gang Li, Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
authors.forename: Wen-Tao
authors.initials: WT
authors.lastname: Fang
authors.affiliation: Bo Ye, Chen-Xi Zhong, Yu Yang, Wen-Tao Fang, Teng Mao, Chun-Yu Ji, Zhi-Gang Li, Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
authors.forename: Teng
authors.initials: T
authors.lastname: Mao
authors.affiliation: Bo Ye, Chen-Xi Zhong, Yu Yang, Wen-Tao Fang, Teng Mao, Chun-Yu Ji, Zhi-Gang Li, Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
authors.forename: Chun-Yu
authors.initials: CY
authors.lastname: Ji
authors.affiliation: Bo Ye, Chen-Xi Zhong, Yu Yang, Wen-Tao Fang, Teng Mao, Chun-Yu Ji, Zhi-Gang Li, Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Li
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D002681:China; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061226:Recurrent Laryngeal Nerve Injuries / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Esophageal cancer; Lymph node; Minimally invasive; Surgery