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Comparison of Open and Thoracoscopic Esophagectomy in Patients With Locally Advanced Esophageal Squamous Cell Carcinoma After Neoadjuvant Therapy

Background/Aim: The safety and effectiveness of thoracoscopic compared with open esophagectomy remain uncertain. We aimed to clarify the differences between these surgical modalities in patients with esophageal squamous cell carcinoma (ESCC) who underwent neoadjuvant therapy. Patients and Methods: We reviewed surgical outcomes among 133 patients with locally advanced ESCC who underwent neoadjuvant therapy followed by esophagectomy. We compared the operative outcomes, postoperative complications and survival rates between 65 and 68 patients who were respectively treated by open and thoracoscopic esophagectomy. Results: The surgical duration was longer, but blood loss was lower during thoracoscopic, compared with open esophagectomy. The numbers of dissected mediastinal lymph nodes and rates of postoperative complications did not significantly differ between open and thoracoscopic esophagectomy. However, the rates of postoperative pneumonia and recurrent laryngeal nerve paralysis were significantly lower and higher, respectively, after thoracoscopic, compared with open esophagectomy. Overall survival did not significantly differ between the groups. Conclusion: Thoracoscopic esophagectomy is feasible for patients with locally advanced ESCC who undergo neoadjuvant therapy.