Abstract: Objective To compare the efficacy of two different surgical routes for operable esophageal squamous cell carcinoma (ESCC). Methods A total of 107 patients with middle thoracic ESCC were enrolled and divided into two groups: left transthoracic approach group and Ivor-lewis approach group. Cox regression analysis and Kaplan-Meier curves were used to explore the difference of survival in the two groups. Postoperative complications, information on lymph node dissection and other clinical factors were compared using non-parametric test and Chi-Square test. Results There were no significant differences between the two groups in the patients' characteristics, overall survival (P=0.315), recurrence-free survival (P=0.246), chest drainage volume (P=0.241), number of resected (P=0.065) and positive lymph nodes (P=0.188). However, blood loss (P=0.007) and operation time (P=0.042) were significantly less or shorter in left transthoracic approach group. T status (P=0.001), N status (P=0.007), as well as metastatic lymph node ratio (MLR, P=0.040), were shown as independent prognostic risk factors by COX regression analysis. Conclusion Both Ivor-Lewis approach and left transthoracic approach are optional surgical routes for operable middle thoracic ESCC.

Key words: Lymph node excision, Esophageal squamous cell carcinoma, Esophagectomy