BACKGROUND: Minimally invasive esophagectomy is an evolving alternative to the open technique with the goal of providing efficient oncological therapy while minimizing morbidity by diminishing surgical trauma. PATIENTS AND METHODS: Fifty-five consecutive esophagectomies with a minimally invasive approach were included in the calculations. The patients' demography, surgical, histopathological and survival outcomes were analyzed, and surgical/ non-surgical morbidity rates calculated. RESULTS: In 47% of the patients, a laparoscopic-thoracoscopic approach, and in 53% minimally invasive hybrid procedures were performed. The overall conversion rate to open surgery was 5.5%. Major surgical complications occurred in 26% and major non-surgical morbidity in 13% of the patients. The curative resection rate was 87% with a median number of investigated lymph-nodes of 17.5. The 1-year disease-free survival and overall survival were 73% and 88%, respectively. No hospital mortality occurred. CONCLUSION: Minimally invasive oncological resection in patients with esophageal cancer is feasible and provides the potential of reducing postoperative morbidity and enhancing the oncological outcome even when a learning curve is included.
BACKGROUND: Minimally invasive esophagectomy is an evolving alternative to the open technique with the goal of providing efficient oncological therapy while minimizing morbidity by diminishing surgical trauma. PATIENTS AND METHODS: Fifty-five consecutive esophagectomies with a minimally invasive approach were included in the calculations. The patients' demography, surgical, histopathological and survival outcomes were analyzed, and surgical/ non-surgical morbidity rates calculated. RESULTS: In 47% of the patients, a laparoscopic-thoracoscopic approach, and in 53% minimally invasive hybrid procedures were performed. The overall conversion rate to open surgery was 5.5%. Major surgical complications occurred in 26% and major non-surgical morbidity in 13% of the patients. The curative resection rate was 87% with a median number of investigated lymph-nodes of 17.5. The 1-year disease-free survival and overall survival were 73% and 88%, respectively. No hospital mortality occurred. CONCLUSION: Minimally invasive oncological resection in patients with esophageal cancer is feasible and provides the potential of reducing postoperative morbidity and enhancing the oncological outcome even when a learning curve is included.
Authors: Sebastian F Schoppmann; Gerhard Prager; Felix B Langer; Franz M Riegler; Barbara Kabon; Edith Fleischmann; Johannes Zacherl Journal: Surg Endosc Date: 2010-05-13 Impact factor: 4.584