Oesophageal carcinoma (EC) is the eighth most common cancer. Surgery is the cornerstone of management for resectable EC. Trans-thoracic oesophagectomy (TTE) and trans-hiatal oesophagectomy (THE) are the two most widely practised procedures. Most of the related controversies are centred on both early and late post-operative complications and mortality (in terms of overall survival and cancer-free survival). This was a single-centre, retrospective, comparative study analysing the outcomes of two EC resection methods. All 87 patients underwent surgery by the same surgical team over 13 years. Consequently, 87 oesophagectomies with curative intent were performed and divided into the TTE group (group A = 47) and the THE group (group B = 40). The mean patient age was 65.60 ± 6.30 years in the TTE group and 63.48 ± 9.34 years in the THE group. No significant difference was found in operative time, blood loss or duration of stay in the intensive care unit. The duration of hospital stay was significantly different between the THE and TTE groups (17.25 ± 5.92 vs. 12.93 ± 3.44, respectively; P ≤ 0.001). In-hospital mortality was higher in the TTE group (9/47, 19.14%) than in the THE group (5/40, 12.5%) (P = 0.400). The mean survival rate from our series showed the superiority of group A (TTE) (65.56 months) over group B (THE) (45.01 months), with P = 0.146. No high level of evidence suggests the superiority of one surgical procedure over another. The THE procedure is less time-consuming concerning care and follow-up, and most patients were more satisfied and experienced less pain than with the TTE procedure. Both THE and TTE have comparable post-operative anastomotic complications, and they have no significant long-term survival differences.

中文翻译：

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经胸与经裂孔食管切除术治疗食管癌：单中心病例系列的回顾性比较研究


食管癌（EC）是第八大常见癌症。手术是可切除 EC 治疗的基石。经胸食管切除术（TTE）和经裂孔食管切除术（THE）是两种最广泛实施的手术。大多数相关争议都集中在早期和晚期术后并发症和死亡率（总生存期和无癌生存期）。这是一项单中心、回顾性、比较研究，分析了两种 EC 切除方法的结果。所有 87 名患者均由同一手术团队在 13 年内接受了手术。因此，进行了 87 例具有治疗目的的食管切除术，并分为 TTE 组（A 组 = 47）和 THE 组（B 组 = 40）。 TTE 组患者的平均年龄为 65.60 ± 6.30 岁，THE 组患者的平均年龄为 63.48 ± 9.34 岁。手术时间、失血量或重症监护病房停留时间没有显着差异。 THE 组和 TTE 组的住院时间存在显着差异（分别为 17.25 ± 5.92 与 12.93 ± 3.44；P ≤ 0.001）。 TTE 组的院内死亡率（9/47，19.14%）高于 THE 组（5/40，12.5%）（P = 0.400）。我们的系列的平均生存率显示 A 组 (TTE)（65.56 个月）优于 B 组（THE）（45.01 个月），P = 0.146。没有高水平的证据表明一种外科手术优于另一种外科手术。与 TTE 手术相比，THE 手术在护理和随访方面耗时较少，大多数患者更满意且疼痛更少。 THE 和 TTE 的术后吻合并发症相当，并且没有显着的长期生存差异。