Laparoscopic versus open abdominal lymph node dissection for esophageal squamous cell carcinoma: a propensity score matching analysis

• Published in: Surgery today (Tokyo, Japan) Vol. 54; no. 12; pp. 1445 - 1452
• Main Authors: Ofuchi, Takashi, Iwatsuki, Masaaki, Matsumoto, Chihiro, Toihata, Tasuku, Kosumi, Keisuke, Baba, Yoshifumi, Miyamoto, Yuji, Yoshida, Naoya, Baba, Hideo
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.12.2024
• Subjects: Abdomen - surgery; Aged; Esophageal Neoplasms - mortality; Esophageal Neoplasms - pathology; Esophageal Neoplasms - surgery; Esophageal Squamous Cell Carcinoma - mortality; Esophageal Squamous Cell Carcinoma - pathology; Esophageal Squamous Cell Carcinoma - surgery; Esophagectomy - methods; Female; Humans; Laparoscopy - methods; Lymph Node Excision - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Propensity Score; Retrospective Studies; Surgery; Surgical Oncology; Surgical Wound Infection - epidemiology; Surgical Wound Infection - etiology; Survival Rate; Time Factors; Treatment Outcome; Esophagectomy; Minimal invasive surgery; Esophageal squamous cell carcinoma; Laparoscopic abdominal lymph node dissection; Propensity score matching analysis
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-024-02874-2

Purpose To compare the short- and long-term outcomes of laparoscopic and open abdominal lymph node dissection using propensity score matching (PSM) analysis. Methods The subjects of this retrospective analysis were 459 patients who underwent curative resection for esophageal squamous cell carcinoma (ESCC) between May, 2005 and December, 2019, at our hospital. Patients were divided into two groups: the Laparoscopic (Lap group) and the Open (Open group). Post-PSM, 139 patients from each group were selected for the analysis to compare the short- and long-term outcomes between the groups. Results The Lap group experienced fewer Clavien-Dindo (CD) Grade ≥ 2 complications (28.1% vs. 40.3%, P = 0.04) and lower rates of abdominal surgical site infections (SSI) (2.9% vs. 7.9%, P = 0.02) than the Open group. The number of lymph nodes harvested was similar in the Lap and Open groups (14.8 ± 7.5 vs. 15.7 ± 8.6, P = 0.34). There was no significant difference in 3-year overall survival rates (81.2% vs. 69.5%, P = 0.12) or relapse-free survival rates (61.1% vs. 58.2%, P = 0.54) between the groups. Conclusions Laparoscopic abdominal lymph node dissection for ESCC can be performed safely and appears to be beneficial.