Surgical approach for Siewert type II adenocarcinoma of the esophagogastric junction: transthoracic or transabdominal? -a single-center retrospective study

Background: The surgical approach (transthoracic or transabdominal) for patients with Siewert type II adenocarcinoma of the esophagogastric junction (AEG) still remains controversial. Methods: Data of patients with Siewert type II AEG were collected in the Guangdong General Hospital from 2004 to 2014 and we compared their clinicopathological outcome and prognosis in regard to the transthoracic (TT) and transabdominal (TA) approach. Results: A total of 158 patients with Siewert type II AEG were analyzed and our results demonstrated that their overall medium survival was 52 months. Also, their 5-year overall survival rate was 39.1%, which was comparable between the TT and TA group (35.1% vs. 43.2%, P>0.05), while more lymph nodes were dissected in TA group (23.7 +/- 0.2 vs. 18.1 +/- 0.3, P<0.05), with less postoperative complications (14.3% vs. 28.4%, P<0.05) and shorten hospital stay (12 +/- 4 vs. 15 +/- 7 d, P<0.05). Conclusions: For patients with Siewert type II AEG, the TA approach is more suitable to achieve an optimal extent of lymph node dissection, reduction in the incidence of complication, shorten hospital stay, and to promote the recovery.