Comparison of laparoscope combined left thorax small incision and left thorax single-incision therapy for Siewert Ⅱ/Ⅲ adenocarcinoma of the esophagogastric junction

Objective To explore the feasibility of laparoscope combined left thorax small incision therapy in the treatment of Siewert Ⅱ/Ⅲ adenocarcinoma of the esophagogastric junction (AEG),and compared with the single-incision treatment in surgical trauma,safety and efficacy on tumor/lymph node dissection. Methods A retrospective analysis was done on 193 patients with Siewert Ⅱ/Ⅲ AEG in Linzhou city people's hospital from October,2014 to December,2015,including 58 cases of laparoscope combined left thorax small incision therapy and 135 cases of left thorax single-incision therapy.The operation time,intraoperative bleeding,total drainage volume,indwelling pleural catheter time,and mediastinal/celiac lymph node dissection number were compared and statistically analyzed. Results The laparoscope combined left thorax small incision treatment has a longer operation time(P<0.05).However,it has advantage on intraoperative bleeding,total drainage volume,postoperative hospitalization days,celiac lymph node dissection number,VAS pain score(P<0.05).No statistical significance was obtained in indwelling pleural catheter time and mediastinal lymph node dissection number(P>0.05).Low occurrence of postoperative implications and no perioperative period death were found in these cases. Conclusion Laparoscope combined left thorax small incision therapy in the treatment of Siewert Ⅱ/Ⅲ AEG is with the advantage of smaller wound,quicker postoperative recovery,less intraoperative pain,clearer celiac lymph node dissection,better esophagus-stomach anastomosis and more perservation of the esophagus at tumor upper margin,which is worthy of application.