本研究旨在比较经改良和传统胸腔腹腔麦基扬手术治疗食管癌患者的疗效和术后生活质量。本回顾性病例对照研究纳入了2020年2月至2022年8月期间在中国的三家医疗中心入院的269例食管癌患者。根据手术方式将患者分为分层手缝端对侧吻合组（改良组）和传统手缝吻合组（传统组）。倾向性评分匹配（PSM）用于保持两组之间的平衡和可比性。传统组和改良组患者的年龄和肿瘤位置差异在PSM前具有统计学意义，而在PSM后这些因素的差异变得统计学无意义。经过PSM之后，每组均有101例患者。改良组在术后住院时间（P = 0.036）、吻合口瘘发生率（P = 0.009）和胃食管反流发生率（P < 0.001）方面显示较大优势，并且这些差异具有统计学意义。生活质量问卷核心30（QLQ-C30）和食管癌模块18问卷（QLQ-OES18）的结果显示，在术后一、三个月的生理功能、整体健康状况、食欲减退、进食、反流、梗阻和食欲减退得分方面，改良组也比传统组更具优势。改良胸腔腹腔麦基扬手术是一种安全有效的手术方法，能显著降低术后吻合口瘘和胃食管反流的发生率，缩短术后住院时间，并改善食管癌患者的术后生活质量。© 2023年 外科肿瘤学学会。

This study aimed to compare the efficacy and postoperative quality of life for patients with esophageal cancer treated by either the modified or the traditional thoracolaparoscopic McKeown procedure.This retrospective case-control study included 269 patients with esophageal cancer admitted to three medical centers in China from February 2020 to August 2022. The patients were divided according to surgical method into the layered hand-sewn end-to-end invagination anastomosis group (modified group) and the traditional hand anastomosis group (traditional group). Propensity score-matching (PSM) was used to maintain balance and comparability between the two groups.The differences in age and tumor location between the patients in the traditional and modified groups were statistically significant. After PSM, the aforementioned factors were statistically insignificant. After PSM, each group had 101 patients. The modified group showed the greater advantage in terms of postoperative hospital stay (P = 0.036), incidence of anastomotic leak (P = 0.009), and incidence of gastroesophageal reflux (P < 0.001), and the difference was statistically significant. The results of the Quality of Life Questionnaire Core 30 (QLQ-C30) and Quality of Life Questionnaire Oesophageal Cancer Module 18 (QLQ-OES18) scales showed that the modified group also had the advantage over the traditional group in terms of physical function, overall health status, loss of appetite, eating, reflux, obstruction, and loss of appetite scores at the first and third months after surgery.The modified thoraco-laparoscopic McKeown procedure is a safe and effective surgical approach that can significantly reduce the incidence of postoperative anastomotic leak and gastroesophageal reflux, shorten the postoperative hospital stay, and improve the postoperative quality of life for patients with esophageal cancer.© 2023. Society of Surgical Oncology.