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Table 3. Postoperative morbidity, mortality and pathologic examination
Characteristics TMIIL (n = 13) HIL (n = 14) P value
Postoperative complications CD < 3, n (%) 3 (15) 4 (28.5) 0.6483
Postoperative complications CD ≥ 3, n (%) 2 (15) 2 (14) 1
Leaks, n (%) 1 (8%) 2 (14%) 1
Pulmonary complications 2 (15) 2 (14) 1
Overall morbidity, n (%) 5 (38) 6(43) 1
Mortality 0 0 n.s
Lenght of hospital stay (day), median (range) 13 (8-24) 14 (8-72) 0.5596
90-days readmission rate, n (%) 0 0 n.s
Pathological stage
< II 5 3 0.4197
≥ II 8 11
R1 resection 0 2 0.4814
Lomph nodes harvested, median (range) 23 (7-71) 27 (7-44) 0.5602

Figure 2. Quality of Life C-30 (preoperative, 7 and 90-day after surgery)

DISCUSSION
The Ivor-Lewis procedure represents the current indication for patients with cancers located in the middle,
distal esophagus and EGJ; although the McKeown procedure avoids the occurrence of intrathoracic leaks,
the rate of dehiscence and strictures is higher in patients with cervical anastomosis independently from
the access route whether open or MI . Injury to the recurrent laryngeal nerve, a complication associated
[10]
with considerable morbidity, is less common if dissection in the neck is avoided [11,12] . As demonstrated by
Mariette, intrathoracic anastomosis provides a lower 30-day postoperative morbidity rate compared to
cervical anastomosis, and thoracotomy itself does not significantly influence postoperative morbidity .
[13]
In recent years particular attention has focused on improving the postoperative results of the IL procedure
through application of MI approaches. Few studies, mainly retrospective, have been published in the current
literature comparing HIL and OIL. Recently, a randomized prospective study by the French Eso-Gastric