Short-Term Outcomes of Minimally Invasive Ivor-Lewis Esophagectomy for Esophageal Cancer

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Abstract

Background.

Esophagectomy represents the gold standard in the treatment of resectable esophageal carcinoma. This retrospective study evaluated the significance of minimally invasive Ivor-Lewis esophagectomy (MIILE) for the treatment of esophageal carcinoma.

Methods.

We retrospectively evaluated 269 patients with esophageal carcinoma who received Ivor-Lewis esophagectomy in our center between October 2011 and January 2013. Of those 269 patients, 106 underwent MIILE and 163 underwent open Ivor-Lewis esophagectomy (OILE). The clinicopathologic factors, operational factors, and postoperative complications were compared.

Results.

The two groups were similar in terms of age, sex, smoking history, American Society of Anesthesiologists grade, tumor location, preoperative staging, and incidence of comorbidities. The MIILE approach was associated with a significant decrease in surgical blood loss (p= 0.04), chest tube duration (p= 0.02), and postoperative stay (p= 0.02) relative to the OILE approach. The postoperative in-hospital mortality and total morbidity did not differ between the two groups. The MIILE approach was associated with significantly fewer wound infections than the OILE approach (p= 0.04). There were no significant differences between the two groups in the number of total lymph nodes dissected (p= 0.69) or the locations of the total lymph nodes dissected (p= 0.42).

Conclusions.

Our MIILE technique can be safely and effectively performed for intrathoracic anastomosis during esophageal operations with favorable early outcomes.

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