Results of the introduction of a minimally invasive esophagectomy program in a tertiary referral center.

Abstract:

BACKGROUND:Esophagectomy is accompanied by a high postoperative complication rate. Minimally invasive esophageal surgery appears to be a promising technique that might be associated with a lower pulmonary morbidity rate. The objective of this study was to describe the implementation of minimally invasive esophageal surgery in a tertiary referral center and to compare the results of our first series of minimally invasive esophagectomies (MIE) to conventional open esophagectomies. METHODS:MIE was implemented after several procedures had been proctored by a surgeon with extensive experience with MIE. Preoperative characteristics and the postoperative course of patients who underwent a transthoracic esophagectomy were prospectively registered. Morbidity and overall hospital stay were compared between minimally invasive and open resections performed in the same period. RESULTS:A total of 90 consecutive esophageal cancer patients underwent a transthoracic resection, 41 patients by means of a minimally invasive approach. Preoperative characteristics were comparable for both groups. The duration of surgery was longer in the MIE group (6.0 vs. 5.2 hours, P<0.001) and median blood loss was lower [100 vs. 500 mL (P<0.001)]. There was only a trend towards a shorter hospital stay in the MIE group (11 vs. 13 days, P=0.072), pulmonary complications occurred in 20% of patients in the MIE group vs. 31% in the open group (P=0.229). The overall complication rate was 51% in the MIE group vs. 63% in the open group, P=0.249. CONCLUSIONS:Implementation of MIE in our center was successful and it appears to be a safe technique for patients with potentially curable esophageal carcinoma.

journal_name

J Thorac Dis

authors

Blom RL,Klinkenbijl JH,Hollmann MW,Bergman JJ,Cuesta MA,Bemelman WA,Busch OR,van Berge Henegouwen MI

doi

10.3978/j.issn.2072-1439.2012.09.05

subject

Has Abstract

pub_date

2012-10-01 00:00:00

pages

467-73

issue

5

eissn

2072-1439

issn

2077-6624

pii

jtd-04-05-467

journal_volume

4

pub_type

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