Minimally invasive oesophagectomy for carcinoma oesophagus--approaches and options in a high volume tertiary centre.

Minimally invasive oesophagectomy is being increasingly performed for treatment of carcinoma oesophagus. In this article, we overview the different types of minimally invasive oesophagectomies we used in our experience. To present an overview of the different types of minimally invasive oesophagectomies used to treat carcinoma oesophagus and to propose a simple working algorithm for surgical management of carcinoma oesophagus, a retrospective review of patients with carcinoma oesophagus who were operated at this centre during the period 1997-2009 was made. Data regarding type of surgery, level of growth, type of carcinoma, and complications were reviewed. A total of 463 patients underwent minimally invasive oesophagectomy for carcinoma oesophagus. Of these, 121 patients (26%) were female. There were no conversions. The mean age of patients was 61.6 years (range 36 years-77 years). Most patients (n = 330; 71%) had squamous cell carcinoma while 133 patients (29%) had adenocarcinoma. Overall mortality was 0.9%. Overall morbidity was 16%. Minimally invasive approaches to oesophagectomy are safe and the type of approach has to be tailored for the histology, level and stage of growth.