Comparison of Outcomes After McKeown and Ivor Lewis Esophagectomy for Lower Third Esophageal Cancer

The commonly performed surgical procedures for esophageal cancer are McKeown and Ivor Lewis esophagectomy. The Ivor Lewis esophagectomy is mainly performed for lower esophageal cancer. Herein, we analyzed both procedures performed for lower esophageal cancer to look for perioperative and survival outcomes. The surgical data was retrieved from the computerized database, and the patients operated on for lower esophageal cancer from 2014 to 2019 were included. Both procedures were analyzed for demographic details, perioperative outcomes, complication rate, and overall and disease-free survivals. A total of 90 patients undergoing esophagectomy for lower esophageal cancer. RLN palsy and anastomotic leak rate were higher in the McKeown group. The estimated 5-year OS was 49% and 58.3% in the McKeown and Ivor Lewis groups, respectively, whereas the estimated 5-year DFS was 41% and 63.9%. In the Ivor Lewis group, on comparing both histological subtypes, the estimated 5-year OS was 74% and 26.3% ( p < 0.05) whereas the DFS was 74.5% and 42% ( p = 0.07) for SCC and adenocarcinoma, respectively. This study did not find a significant difference in the perioperative as well as survival outcomes comparing McKeown esophagectomy with the Ivor Lewis procedure for lower third esophageal cancer. A prospective trial is warranted to see the difference.