Ju-Wei Mu1, Shu-Geng Gao1, Qi Xue1, You-Sheng Mao1, Da-Li Wang1, Jun Zhao1, Yu-Shun Gao1, Jin-Feng Huang1, Jie He1. 1. Ju-Wei Mu, Shu-Geng Gao, Qi Xue, You-Sheng Mao, Da-Li Wang, Jun Zhao, Yu-Shun Gao, Jin-Feng Huang, Jie He, Department of Thoracic Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Abstract
AIM: To update our experiences with minimally invasive McKeown esophagectomy for esophageal cancer. METHODS: We retrospectively reviewed the medical records of 445 consecutive patients who underwent minimally invasive McKeown esophagectomy between January 2009 and July 2015 at the Cancer Hospital of Chinese Academy of Medical Sciences and used 103 patients who underwent open McKeown esophagectomy in the same period as controls. Among 375 patients who underwent total minimally invasive McKeown esophagectomy, 180 in the early period were chosen for the study of learning curve of total minimally invasive McKeown esophagectomy. These 180 minimally invasive McKeown esophagectomies performed by five surgeons were divided into three groups according to time sequence as group 1 (n = 60), group 2 (n = 60) and group 3 (n = 60). RESULTS: Patients who underwent total minimally invasive McKeown esophagectomy had significantly less intraoperative blood loss than patients who underwent hybrid minimally invasive McKeown esophagectomy or open McKeown esophagectomy (100 mL vs 300 mL vs 200 mL, P = 0.001). However, there were no significant differences in operation time, number of harvested lymph nodes, or postoperative morbidity including incidence of pulmonary complication and anastomotic leak between total minimally invasive McKeown esophagectomy, hybrid minimally invasive McKeown esophagectomy and open McKeown esophagectomy groups. There were no significant differences in 5-year survival between these three groups (60.5% vs 47.9% vs 35.6%, P = 0.735). Patients in group 1 had significantly longer duration of operation than those in groups 2 and 3. There were no significant differences in intraoperative blood loss, number of harvested lymph nodes, or postoperative morbidity including incidence of pulmonary complication and anastomotic leak between groups 1, 2 and 3. CONCLUSION: Total minimally invasive McKeown esophagectomy was associated with reduced intraoperative blood loss and comparable short term and long term survival compared with hybrid minimally invasive McKeown esophagectomy or open Mckeown esophagectomy. At least 12 cases are needed to master total minimally invasive McKeown esophagectomy in a high volume center.
AIM: To update our experiences with minimally invasive McKeown esophagectomy for esophageal cancer. METHODS: We retrospectively reviewed the medical records of 445 consecutive patients who underwent minimally invasive McKeown esophagectomy between January 2009 and July 2015 at the Cancer Hospital of Chinese Academy of Medical Sciences and used 103 patients who underwent open McKeown esophagectomy in the same period as controls. Among 375 patients who underwent total minimally invasive McKeown esophagectomy, 180 in the early period were chosen for the study of learning curve of total minimally invasive McKeown esophagectomy. These 180 minimally invasive McKeown esophagectomies performed by five surgeons were divided into three groups according to time sequence as group 1 (n = 60), group 2 (n = 60) and group 3 (n = 60). RESULTS:Patients who underwent total minimally invasive McKeown esophagectomy had significantly less intraoperative blood loss than patients who underwent hybrid minimally invasive McKeown esophagectomy or open McKeown esophagectomy (100 mL vs 300 mL vs 200 mL, P = 0.001). However, there were no significant differences in operation time, number of harvested lymph nodes, or postoperative morbidity including incidence of pulmonary complication and anastomotic leak between total minimally invasive McKeown esophagectomy, hybrid minimally invasive McKeown esophagectomy and open McKeown esophagectomy groups. There were no significant differences in 5-year survival between these three groups (60.5% vs 47.9% vs 35.6%, P = 0.735). Patients in group 1 had significantly longer duration of operation than those in groups 2 and 3. There were no significant differences in intraoperative blood loss, number of harvested lymph nodes, or postoperative morbidity including incidence of pulmonary complication and anastomotic leak between groups 1, 2 and 3. CONCLUSION: Total minimally invasive McKeown esophagectomy was associated with reduced intraoperative blood loss and comparable short term and long term survival compared with hybrid minimally invasive McKeown esophagectomy or open Mckeown esophagectomy. At least 12 cases are needed to master total minimally invasive McKeown esophagectomy in a high volume center.
Authors: Philippe Nafteux; Johnny Moons; Willy Coosemans; Herbert Decaluwé; Georges Decker; Paul De Leyn; Dirk Van Raemdonck; Toni Lerut Journal: Eur J Cardiothorac Surg Date: 2011-04-22 Impact factor: 4.191
Authors: Francesco Palazzo; Ernest L Rosato; Asadulla Chaudhary; Nathaniel R Evans; Jocelyn A Sendecki; Scott Keith; Karen A Chojnacki; Charles J Yeo; Adam C Berger Journal: J Am Coll Surg Date: 2014-12-27 Impact factor: 6.113
Authors: Ulrich Ronellenfitsch; Matthias Schwarzbach; Ralf Hofheinz; Peter Kienle; Meinhard Kieser; Tracy E Slanger; Bryan Burmeister; David Kelsen; Donna Niedzwiecki; Christoph Schuhmacher; Susan Urba; Cornelis van de Velde; Thomas N Walsh; Marc Ychou; Katrin Jensen Journal: Eur J Cancer Date: 2013-06-22 Impact factor: 9.162
Authors: Surya S A Y Biere; Mark I van Berge Henegouwen; Kirsten W Maas; Luigi Bonavina; Camiel Rosman; Josep Roig Garcia; Suzanne S Gisbertz; Jean H G Klinkenbijl; Markus W Hollmann; Elly S M de Lange; H Jaap Bonjer; Donald L van der Peet; Miguel A Cuesta Journal: Lancet Date: 2012-05-01 Impact factor: 79.321
Authors: K Kumagai; I Rouvelas; J A Tsai; D Mariosa; P A Lind; M Lindblad; W Ye; L Lundell; C Schuhmacher; M Mauer; B H Burmeister; J M Thomas; M Stahl; M Nilsson Journal: Eur J Surg Oncol Date: 2014-11-27 Impact factor: 4.424