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. 2020 Oct-Dec;24(4):e2020.00060.
doi: 10.4293/JSLS.2020.00060.

Minimally Invasive Esophagectomy for Achieving R0

Muhammad B Darwish  1 , Kei Nagatomo  1 , Terence Jackson  1 , Edward Cho  1 , Houssam Osman  1 , D Rohan Jeyarajah  2   3
Affiliations

Minimally Invasive Esophagectomy for Achieving R0

Muhammad B Darwish et al. JSLS. 2020 Oct-Dec.

Abstract

Background: Minimally invasive esophagectomy (MIE) is becoming increasing popular. Since it was introduced, there has been debate about its safety and efficacy when compared with open esophagectomies (OE). We sought to compare the oncologic outcomes of MIE and OE in this study specifically with regards to margin status and nodal retrieval.

Methods: Ninety-three patients that underwent MIE (76/93) or OE (17/93) for esophageal cancer at out institution between January 2013 and September 2018 were retrospectively reviewed. Histological type, pathological tumor grading, clinical tumor staging (cTNM), pathological tumor staging (pTNM), post-neoadjuvant tumor staging (ypTNM), and lymph node retrieval were obtained and compared.

Results: The results show a statistically significant improvement in resection margins (R0) in the MIE group when compared with the OE group. Other oncologic parameters including clinical staging, pathologic staging, tumor grade, neoadjuvant therapy (NAT), and nodal retrieval were not statistically significantly different between the open and MIE groups.

Conclusion: The improvement in short-term surgical outcomes in MIE is well established. This study demonstrates that MIE can have superior surgical oncologic outcomes compared to OE, this was specifically an improved R0 margin rate with MIE compared to OE. These results further support the use of MIE in the treatment of esophageal cancer.

Keywords: Esophageal Cancer; Minimally Invasive Esophagectomy; Oncologic Outcome; Open Esophagectomy; Robotic-assisted Esophagectomy.

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Conflict of interest statement

Conflicts of Interest: The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Distribution of Tumor Grading.
Figure 2.
Figure 2.
Distribution of Clinical Tumor Staging.
Figure 3.
Figure 3.
Distribution of Pathologic Tumor Staging.
See this image and copyright information in PMC

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