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Background  The aim of this study was to compare the short‐term outcomes and three‐year survival between dual‐incision esophagectomy ( DIE ) and total minimally invasive  M c K eown esophagectomy ( MIME ) for esophageal cancer patients with negative upper mediastinal lymph nodes requiring esophagectomy and neck anastomosis.    Methods  One hundred and fifty patients underwent  DIE , while 361 patients received total  MIME . Perioperative outcomes and three‐year survival were compared in unmatched and propensity score matched data between two groups.    Results  Both unmatched and matched analysis demonstrated that there were no significant differences in the number of lymph nodes harvested, or major or minor complication rates between the  DIE  and  MIME  groups. Compared with patients who underwent  DIE , patients who underwent total  MIME  had longer operation duration (310 minutes vs. 345 minutes;   P   = 0.002). However, there was significantly less intraoperative blood loss in the total  MIME  compared with the  DIE  group (191 m L  vs. 287 m L , respectively;   P   < 0.001).  K aplan‐ M eier analysis demonstrated a trend that patients who underwent  MIME  had longer overall (79.5% vs. 64.1%;   P   = 0.063) and disease‐free three‐year survival (65.3% vs. 82.8%;   P   = 0.058) compared with patients who underwent  DIE .    Conclusions  Both total  MIME  and  DIE  are feasible for the surgical treatment of esophageal cancer patients with negative upper mediastinal lymph nodes requiring esophagectomy and neck anastomosis. However,  MIME  was associated with better overall and disease‐free three‐year survival compared with  DIE .

Comparison of short‐term outcomes and three yearsurvival between total minimally invasive M c K eown and dual‐incision esophagectomy