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首页> 外文期刊>Surgical Endoscopy >Long-term oncological outcomes of laparoscopic versus open transhiatal resection for patients with Siewert type II adenocarcinoma of the esophagogastric junction
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Long-term oncological outcomes of laparoscopic versus open transhiatal resection for patients with Siewert type II adenocarcinoma of the esophagogastric junction

机译：腹腔镜的长期肿瘤结果与Siewert II型腺癌患者的腹腔镜与开放的转枝状切除术治疗食管古代交界处的腺癌

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Background Insufficient information is available about the long-term outcomes of patients with Siewert type II adenocarcinoma of the esophagogastric junction (AEG) who undergo laparoscopic transhiatal approach (LTH). Here we evaluated the oncological safety of LTH for patients with Siewert type II AEG compared with the open transhiatal approach (OTH). Methods Subjects included 79 patients with Siewert type II AEG who underwent gastrectomy combined with lower esophagectomy from 2008 to 2018 at our institution. Overall survival (OS), recurrence-free survival (RFS), status of adjuvant chemotherapy, late-phase complications, and recurrence patterns were compared between the OTH (n = 29) and LTH groups (n = 43). Results The median observation periods were 60 months (6-120 months) and 36 months (1-88) for the OTH and LTH groups, respectively. The 5-year OS rates were significantly different: 74% (95% CI 71-77%) and 98% (95% CI 97-99) in the OTH and LTH groups (HR 0.10, 95% CI 0.01-0.83), respectively, though the OTH group included more patients with advanced disease. After stratification, according to pathological stage to adjust for selection bias, the 5-year OS and RFS rates were longer, but not significantly different among patients in the LTH group with pStage III (HR 0.42, 95% CI 0.05-3.47; HR 0.47, 95% CI 0.10-2.12, respectively). Recurrence patterns were similar in the both groups. Conclusions Long-term outcomes of the LTH group were not inferior to those of the OTH group, suggesting the possibility of LTH as a treatment option for selected patients with Siewert type II AEG.
机译：背景：关于食管胃交界部Siewert II型腺癌（AEG）患者接受腹腔镜经食管裂孔入路（LTH）的长期预后，目前尚无足够的信息。在这里，我们评估了与开放性经裂孔入路（OTH）相比，对于Siewert II型AEG患者，LTH的肿瘤安全性。方法受试者包括2008年至2018年在我院接受胃切除术联合下食管切除术的79例Siewert II型AEG患者。比较OTH组（n=29）和LTH组（n=43）的总生存率（OS）、无复发生存率（RFS）、辅助化疗状态、晚期并发症和复发模式。结果OTH组和LTH组的中位观察期分别为60个月（6-120个月）和36个月（1-88个月）。5年OS发生率有显著差异：OTH组和LTH组（HR 0.10，95%CI 0.01-0.83）的5年OS发生率分别为74%（95%CI 71-77%）和98%（95%CI 97-99），尽管OTH组包括更多的晚期疾病患者。分层后，根据病理分期调整选择偏差，5年的OS和RFS发生率更长，但在pStage III的LTH组患者中没有显著差异（HR 0.42，95%可信区间0.05-3.47；HR 0.47，95%可信区间0.10-2.12）。两组的复发模式相似。结论LTH组的长期疗效并不低于OTH组，这表明LTH可能是Siewert II型AEG患者的一种治疗选择。

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