B Babic1, L M Schiffmann1, W Schröder1, C J Bruns1, H F Fuchs2. 1. Klinik und Poliklinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland. 2. Klinik und Poliklinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland. hans.fuchs@uk-koeln.de.
Abstract
BACKGROUND: Thoracoabdominal esophagectomy still plays a major role in the oncological treatment for esophageal cancer. Minimally invasive procedures were developed to reduce the high rate of postoperative morbidity and mortality without negatively affecting the oncological outcome. OBJECTIVE: What evidence supports minimally invasive oncological surgery of the esophagus? Do patients benefit from minimally invasive esophagectomy compared to an open approach? Is the reduction of surgical access trauma specifically advantageous? MATERIAL AND METHODS: Review, evaluation and critical analysis of the international literature. RESULTS: A reduction in postoperative morbidity by decreasing surgical trauma was confirmed by three prospective randomized clinical trials, while showing at least similar oncological outcomes. Diverse retrospective analyses and meta-analyses also came to the same result. CONCLUSION: A minimization of surgical access trauma during thoracoabdominal esophagectomy reduces postoperative morbidity compared to conventional open surgery. Recent evidence suggests that oncological outcomes are not altered depending on the surgical approach.
BACKGROUND: Thoracoabdominal esophagectomy still plays a major role in the oncological treatment for esophageal cancer. Minimally invasive procedures were developed to reduce the high rate of postoperative morbidity and mortality without negatively affecting the oncological outcome. OBJECTIVE: What evidence supports minimally invasive oncological surgery of the esophagus? Do patients benefit from minimally invasive esophagectomy compared to an open approach? Is the reduction of surgical access trauma specifically advantageous? MATERIAL AND METHODS: Review, evaluation and critical analysis of the international literature. RESULTS: A reduction in postoperative morbidity by decreasing surgical trauma was confirmed by three prospective randomized clinical trials, while showing at least similar oncological outcomes. Diverse retrospective analyses and meta-analyses also came to the same result. CONCLUSION: A minimization of surgical access trauma during thoracoabdominal esophagectomy reduces postoperative morbidity compared to conventional open surgery. Recent evidence suggests that oncological outcomes are not altered depending on the surgical approach.
Authors: Oliver C Burdall; Alexander P Boddy; James Fullick; Jane Blazeby; Richard Krysztopik; Christopher Streets; Andrew Hollowood; Christopher P Barham; Dan Titcomb Journal: Surg Endosc Date: 2014-08-15 Impact factor: 4.584
Authors: Hans F Fuchs; Cristina R Harnsberger; Ryan C Broderick; David C Chang; Bryan J Sandler; Garth R Jacobsen; Michael Bouvet; Santiago Horgan Journal: Surg Endosc Date: 2016-09-22 Impact factor: 4.584
Authors: Rachel C Brierley; Daisy Gaunt; Chris Metcalfe; Jane M Blazeby; Natalie S Blencowe; Marcus Jepson; Richard G Berrisford; Kerry N L Avery; William Hollingworth; Caoimhe T Rice; Aida Moure-Fernandez; Newton Wong; Joanna Nicklin; Anni Skilton; Alex Boddy; James P Byrne; Tim Underwood; Ravi Vohra; James A Catton; Kish Pursnani; Rachel Melhado; Bilal Alkhaffaf; Richard Krysztopik; Peter Lamb; Lucy Culliford; Chris Rogers; Benjamin Howes; Katy Chalmers; Sian Cousins; Jackie Elliott; Jenny Donovan; Rachael Heys; Robin A Wickens; Paul Wilkerson; Andrew Hollowood; Christopher Streets; Dan Titcomb; Martyn Lee Humphreys; Tim Wheatley; Grant Sanders; Arun Ariyarathenam; Jamie Kelly; Fergus Noble; Graeme Couper; Richard J E Skipworth; Chris Deans; Sukhbir Ubhi; Robert Williams; David Bowrey; David Exon; Paul Turner; Vinutha Daya Shetty; Ram Chaparala; Khurshid Akhtar; Naheed Farooq; Simon L Parsons; Neil T Welch; Rebecca J Houlihan; Joanne Smith; Rachel Schranz; Nicola Rea; Jill Cooke; Alexandra Williams; Carolyn Hindmarsh; Sally Maitland; Lucy Howie; Christopher Paul Barham Journal: BMJ Open Date: 2019-11-19 Impact factor: 2.692
Authors: Kerry N L Avery; Chris Metcalfe; Richard Berrisford; C Paul Barham; Jenny L Donovan; Jackie Elliott; Stephen J Falk; Rob Goldin; George Hanna; Andrew A Hollowood; Richard Krysztopik; Sian Noble; Grant Sanders; Christopher G Streets; Dan R Titcomb; Tim Wheatley; Jane M Blazeby Journal: Trials Date: 2014-06-02 Impact factor: 2.279