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Observational Study
. 2019 Jun 28;14(1):123.
doi: 10.1186/s13019-019-0937-4.

Total laparoscopic and thoracoscopic Ivor Lewis esophagectomy after neoadjuvant Chemoradiation with minimal overall and anastomotic complications

Robert E Merritt  1 , Peter J Kneuertz  2 , Desmond M D'Souza  2 , Kyle A Perry  3
Affiliations
Observational Study

Total laparoscopic and thoracoscopic Ivor Lewis esophagectomy after neoadjuvant Chemoradiation with minimal overall and anastomotic complications

Robert E Merritt et al. J Cardiothorac Surg. .

Abstract

Background: The published rates of morbidity and mortality remain relatively high for patients who undergo laparoscopic and thoracoscopic Ivor Lewis esophagectomy. We report the postoperative and oncologic outcomes of a large cohort of patients with esophageal carcinoma who were uniformly treated with laparoscopic and thoracoscopic Ivor Lewis esophagectomy following neoadjuvant chemoradiation.

Methods: This is a retrospective observational study of 112 patients diagnosed with esophageal carcinoma who underwent total laparoscopic and thoracoscopic Ivor Lewis esophagectomy from May 2014 to May 2018. All of the patients received neoadjuvant chemoradiation consisting of 45 to 50.4 Gray of radiation and 3-5 cycles of carboplatin and paclitaxel chemotherapy. Perioperative morbidity and 90-day mortality were recorded. The overall and disease-free survival rates were estimated by Kaplan Meier techniques.

Results: A total of 112 patients completed induction chemoradiation followed by a total laparoscopic and thoracoscopic Ivor Lewis esophagectomy. There were 87 (77.68%) males and 25 (22.32%) females with a mean age of 61.6 years ± 10.4. A total of 28 (25%) patients had one or more complications. A total of 4 patients (3.57%) had an anastomotic leak. The 90-day mortality rate was 0.89%. The 3-year overall survival rate was 64.7% and the 3-year disease-free survival rate was 70.2%.

Conclusion: The current outcomes suggest that laparoscopic and thoracoscopic Ivor Lewis esophagectomy can be performed with minimal overall and anastomotic complications following neoadjuvant chemoradiation.

Keywords: Esophageal Cancer; Induction therapy; Minimally invasive Esophagectomy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan-Meier Curve for Overall Survival
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Fig. 2
Kaplan-Meier Curve for Disease-Free Survival
Fig. 3
Fig. 3
Pathologic Complete Response Association with Overall Survival
Fig. 4
Fig. 4
Pathologic Complete Response Association with Disease-Free Survival
Fig. 5
Fig. 5
Complication Status Association with Overall Survival
Fig. 6
Fig. 6
Complication Status Association with Disease-Free Survival
See this image and copyright information in PMC

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