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. 2009 Jul;144(7):679-84.
doi: 10.1001/archsurg.2009.113.

Comparison of laparoscopic inversion esophagectomy and open transhiatal esophagectomy for high-grade dysplasia and stage I esophageal adenocarcinoma

Kyle A Perry  1 , C Kristian Enestvedt, Thai Pham, Melissa Welker, Blair A Jobe, John G Hunter, Brett C Sheppard
Affiliations

Comparison of laparoscopic inversion esophagectomy and open transhiatal esophagectomy for high-grade dysplasia and stage I esophageal adenocarcinoma

Kyle A Perry et al. Arch Surg. 2009 Jul.

Abstract

Hypothesis: The perioperative outcomes of laparoscopic inversion esophagectomy (LIE) are comparable to those of open transhiatal esophagectomy (THE), with potential benefits related to the use of minimally invasive techniques.

Design: Case-control study.

Setting: Tertiary care university hospital.

Patients and interventions: From July 1, 2003, through March 31, 2008, 21 consecutive patients underwent LIE for high-grade dysplasia or clinical stage I esophageal cancer. We compared these patients with 21 stage-matched control patients treated with THE from August 1, 1995, through August 31, 2003.

Main outcome measures: Operative time, blood loss, length of hospital stay, perioperative complications, and disease-free survival.

Results: Mean (SD) operative times for LIE (399 [86] minutes) and THE (407 [127] minutes) were not significantly different (P = .80). Patients undergoing LIE had significantly lower intraoperative blood loss (168 mL; P < .001) and overall length of hospital stay (10 days; P = .03) compared with those in the THE group (526 mL and 14 days, respectively). Complication rates were not significantly different between the groups. With a median follow-up of 29 months, there has been 1 systemic recurrence in the LIE group.

Conclusions: Laparoscopic inversion esophagectomy is a safe and effective approach to the treatment of high-grade dysplasia and early esophageal adenocarcinoma. Compared with THE, LIE decreases operative blood loss and length of hospital stay without increasing the operative time, morbidity, or mortality related to esophagectomy.

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