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. 2017 Sep;9(9):3097-3104.
doi: 10.21037/jtd.2017.08.49.

Comparison of perioperative outcomes following hybrid minimally invasive versus open Ivor Lewis esophagectomy for esophageal cancer

Ju Sik Yun  1 , Kook Joo Na  1 , Sang Yun Song  1 , Seok Kim  1 , In Seok Jeong  2 , Sang Gi Oh  2
Affiliations

Comparison of perioperative outcomes following hybrid minimally invasive versus open Ivor Lewis esophagectomy for esophageal cancer

Ju Sik Yun et al. J Thorac Dis. 2017 Sep.

Abstract

Background: The outcomes of various minimally invasive esophagectomy (MIE) procedures for esophageal cancer have been reported; however, those of the hybrid approach are lacking. This study aimed to assess the impacts of hybrid minimally invasive Ivor Lewis esophagectomy (HIL, laparoscopy and right thoracotomy) for esophageal cancer on perioperative outcomes compared with the open approach.

Methods: This was a retrospective study of 153 patients who underwent Ivor Lewis esophagectomy for squamous cell carcinoma between January 2008 and December 2016. Patients who received neoadjuvant treatment prior to surgery (n=22) and underwent complete minimally invasive procedures (n=16) were excluded. Clinical characteristics and perioperative outcomes of patients who underwent HIL (n=53) were compared with findings in patients who underwent open Ivor Lewis esophagectomy (OIL, n=62).

Results: There were 112 men (97.4%) and 3 women (2.6%) with a median age of 66 years (range, 45-83 years). The HIL and OIL groups were comparable with respect to age, sex, preoperative pulmonary function, location of the tumor, and preoperative laboratory findings. There was no significant difference between the two groups regarding surgical data, except for pyloric management. Postoperative complications occurred in 17 (32.1%) and 23 (37.1%) patients in the HIL and OIL groups, respectively (P=0.573); in-hospital mortality rates were 3.8% and 8.1%, respectively (P=0.337). HIL group patients had higher albumin (3.3 vs. 2.9 g/dL; P<0.001) and lower C-reactive protein (6.4 vs. 8.1 mg/L; P<0.001) postoperatively. The length of hospital stay was shorter in the HIL group (13.5 vs. 19.2 days; P=0.002).

Conclusions: Compared with the conventional open approach, HIL for esophageal cancer showed better postoperative nutritional and inflammatory status, resulting in shorter hospital stays. However, further studies are required to evaluate the long-term oncologic outcomes of this hybrid approach.

Keywords: Esophageal cancer; Ivor Lewis esophagectomy; laparoscopy; minimally invasive surgery.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

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References

    1. Mariette C, Piessen G, Triboulet JP. Therapeutic strategies in oesophageal carcinoma: role of surgery and other modalities. Lancet Oncol 2007;8:545-53. 10.1016/S1470-2045(07)70172-9 - DOI - PubMed
    1. Cuschieri A, Shimi S, Banting S. Endoscopic oesophagectomy through a right thoracoscopic approach. J R Coll Surg Edinb 1992;37:7-11. - PubMed
    1. Watanabe M, Baba Y, Nagai Y, et al. Minimally invasive esophagectomy for esophageal cancer: an updated review. Surg Today 2013;43:237-44. 10.1007/s00595-012-0300-z - DOI - PubMed
    1. Dantoc MM, Cox MR, Eslick GD. Does minimally invasive esophagectomy (MIE) provide for comparable oncologic outcomes to open techniques? A systematic review. J Gastrointest Surg 2012;16:486-94. 10.1007/s11605-011-1792-3 - DOI - PubMed
    1. Schoppmann SF, Prager G, Langer FB, et al. Open versus minimally invasive esophagectomy: a single-center case controlled study. Surg Endosc 2010;24:3044-53. 10.1007/s00464-010-1083-1 - DOI - PubMed