Comparison of Three Field and Two Field Esophagectomy for Esophageal Cancer

Esophageal cancer is a common health issue worldwide, often associated with a poor outlook. Surgery is the main treatment, offering the best chance for a cure and long-term survival. However, results have been disappointing despite improvements in postoperative care and surgical techniques. This study aims to compare two surgical approaches: three-field and two-field esophagectomy, focusing on the efficacy of radical lymph node dissection in improving survival and quality of life. This research is important because there's currently no clear evidence on whether three-field lymphadenectomy, a more extensive procedure, significantly improves survival over two-field lymphadenectomy. The study will include patients with biopsy-proven esophageal cancer who are deemed operable and fit for major surgery. In this prospective randomized controlled trial, participants will undergo standard staging investigations, including CT scans and endoscopic ultrasounds. They will then be randomized into two groups, undergoing either three-field or two-field esophagectomy. The study will compare overall survival, disease-free survival, and postoperative complications between the two groups. It will also evaluate short and long-term quality of life after the procedures. All surgeries will be performed under general anesthesia, either by or under the direct supervision of experienced thoracic surgeons.