Comparison of Thoracotomy and Methods without Thoracotomy in the Dissection of Mediastinal Lymph Nodes in Patients with Esophageal Cancer

摘要

Objective: In this study comparison of thoracotomy and methods without thoracotomy methods in the dissection of mediastinal lymph nodes in patients with esophageal cancer was performed.Methods: 24 cases who were operated for esophageal cancer between March 2006-November 2011 were retrospectively examined from the hospital records. Number of thoracic lymph nodes in the pathological specimens were compared between the groups. Mann-Whitney-U test and Fisher's chi-square test were used in statistical analysis. Statistical significance was accepted as P< 0.05.Results: 9 cases were female and 15 cases were male. Average was 57.58 ± 12.04 (minimum 36-maximum 78). The tumors were located in the cervical region in 2 cases, middle thoracic region in 8 cases and in distal esophagus in 14 cases. The cases were diagnosed to be epidermoid carcinoma (n:15), adenocarcinoma (n:7) and mesencyhmal tumor (n:2). 12 cases underwent right thoracotomy + laparotomy + cervical incision, 2 cases underwent left thoracotomy + laparotomy, 4 cases underwent right thoracotomy+laparotomy and 6 cases were operated with the transhiatal technique. According to the pathology reports average mediastinal lymph node number in cases with thoracotomy was 14.11 ± 5.08 (minimum 6, maximum 22). The number of lymph nodes in the transhiatal approach without thoracotomy was 2.33 ± 1.03 (minimum 1, maximum 4). There was no statistical difference between the two groups in average age (P = 0.721) and gender (P = 1.000). The number of lymph nodes dissected with thoracotomy was significantly higher than the methods without thoracotomy (P = 0.000).Conclusion: The number of lymph nodes are important in esophageal cancer staging. Thoraccic approach is more suitable for staging than the transhiatal approach.