Trial reportSurgical endoscopy2026
Ivor Lewis minimally invasive oesophagectomy versus McKeown approach: short-term benefits and mid-term equivalence in a randomized trial for oesophageal squamous cell carcinoma.
Trial report in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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7 authors.
Funding
Abstract
backgroundOesophageal cancer (EC) is a leading cause of cancer-related mortality worldwide. Minimally invasive oesophagectomy (MIE) techniques-such as the Ivor Lewis and McKeown techniques-are widely used to treat mid-lower thoracic oesophageal squamous cell carcinoma (ESCC). However, the comparative efficacy of these techniques remains debated, particularly with respect to mid-term outcomes. This study aimed to compare the short- and mid-term outcomes of Ivor Lewis versus McKeown MIE in patients with mid-lower ESCC. MATERIALS AND
methodsThis prospective randomized controlled trial (July 2020 - June 2024) enrolled 272 ESCC patients at a single Chinese centre. The patients were randomized to the Ivor Lewis (n = 136) or McKeown (n = 136) MIE groups at a 1:1 ratio. The primary endpoint was postoperative complications; the secondary endpoints included operative parameters, laboratory biomarkers, and progression-free survival (PFS). Statistical analyses, including Kaplan-Meier survival analysis, were performed using SPSS 29.0 and R 4.4.2.
resultsThe Ivor Lewis group demonstrated significantly lower complication rates and shorter operative time (median [IQR] 210 [176-240] vs. 285 [245-335] minutes, Mann-Whitney U test, p < 0.001), including the rates of anastomotic leak (8.1 vs. 16.9%, p = 0.03), anastomotic stenosis (6.6% vs. 22.8%, p < 0.001), and recurrent laryngeal nerve injury (0 vs. 3.7%, p = 0.02). Both groups exhibited comparable postoperative inflammatory (WBC and CRP) and nutritional (albumin and prealbumin) laboratory changes. No significant difference in PFS was observed (log-rank p = 0.67).
conclusionCompared with the McKeown approach, Ivor Lewis MIE yields superior short-term outcomes, including reduced operative time and complications. However, there was no significant difference in mid-term survival (as measured by PFS) between the groups.
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