Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Apr;92(4):299-303.
doi: 10.1007/s00104-020-01337-x. Epub 2021 Jan 11.

[Evidence in minimally invasive oncological surgery of the esophagus]

[Article in German]
B Babic  1 , L M Schiffmann  1 , W Schröder  1 , C J Bruns  1 , H F Fuchs  2
Affiliations
Review

[Evidence in minimally invasive oncological surgery of the esophagus]

[Article in German]
B Babic et al. Chirurg. 2021 Apr.

Abstract
in English, German

Background: Thoracoabdominal esophagectomy still plays a major role in the oncological treatment for esophageal cancer. Minimally invasive procedures were developed to reduce the high rate of postoperative morbidity and mortality without negatively affecting the oncological outcome.

Objective: What evidence supports minimally invasive oncological surgery of the esophagus? Do patients benefit from minimally invasive esophagectomy compared to an open approach? Is the reduction of surgical access trauma specifically advantageous?

Material and methods: Review, evaluation and critical analysis of the international literature.

Results: A reduction in postoperative morbidity by decreasing surgical trauma was confirmed by three prospective randomized clinical trials, while showing at least similar oncological outcomes. Diverse retrospective analyses and meta-analyses also came to the same result.

Conclusion: A minimization of surgical access trauma during thoracoabdominal esophagectomy reduces postoperative morbidity compared to conventional open surgery. Recent evidence suggests that oncological outcomes are not altered depending on the surgical approach.

Zusammenfassung: HINTERGRUND: Die thorakoabdominale Ösophagektomie spielt bei der Therapie des Ösophaguskarzinoms weiterhin die tragende Rolle. Minimal-invasive Verfahren wurden entwickelt, um die hohe Rate an postoperativer Morbidität und Mortalität zu reduzieren, ohne das onkologische Ergebnis dabei zu gefährden.

Fragestellung: Welche Evidenz besteht in der minimal-invasiven onkologischen Chirurgie des Ösophagus? Profitieren Patienten von einer minimal-invasiven Ösophagektomie im Vergleich zur offenen Technik? Ist eine Reduktion des chirurgischen Zugangstraumas im Einzelnen von Vorteil?

Material und methodik: Die internationale Literatur wurde gesichtet, ausgewertet und kritisch analysiert.

Ergebnisse: Drei prospektiv randomisierte Studien bestätigen eine Reduktion der postoperativen Morbidität durch die Reduktion des chirurgischen Zugangstraumas bei mindestens gleichwertigem onkologischem Ergebnis. Zu diesem Ergebnis kommen auch diverse retrospektive Analysen sowie Metaanalysen.

Schlussfolgerung: Eine Minimierung des chirurgischen Zugangstraumas bei der thorakoabdominalen Ösophagektomie führt zu einer Reduktion der postoperativen Morbidität im Vergleich zur offenen Chirurgie. Das onkologische Ergebnis bleibt davon nach aktueller Datenlage unbeeinträchtigt.

Keywords: Esophageal cancer; Minimally invasive esophagectomy; Outcome; Robot assisted esophagectomy; Surgical techniques.

PubMed Disclaimer

References

Literatur

    1. Avery KN, Metcalfe C, Berrisford R et al (2014) The feasibility of a randomized controlled trial of esophagectomy for esophageal cancer—the ROMIO (randomized oesophagectomy: minimally invasive or open) study: protocol for a randomized controlled trial. Trials 15:200–210. https://doi.org/10.1186/1745-6215-15-200 - DOI - PubMed - PMC
    1. Brierley RC, Gaunt D, Metcalfe C et al (2019) Laparoscopically assisted versus open oesophagectomy for patients with oesophageal cancer-the randomised oesophagectomy: minimally invasive or open (ROMIO) study: protocol for a randomised controlled trial (RCT). BMJ Open 9:e30907. https://doi.org/10.1136/bmjopen-2019-030907 - DOI - PubMed - PMC
    1. Burdall OC, Boddy AP, Fullick J et al (2014) A comparative study of survival after minimally invasive and open oesophagectomy. Surg Endosc 29:431–437. https://doi.org/10.1007/s00464-014-3694-4 - DOI - PubMed
    1. Chao Y‑K, Li Z‑G, Wen Y‑W et al (2019) Robotic-assisted esophagectomy vs video-assisted thoracoscopic esophagectomy (REVATE): study protocol for a randomized controlled trial. Trials. https://doi.org/10.1186/s13063-019-3441-1 - DOI - PubMed - PMC
    1. Cuschieri A (1993) Endoscopic subtotal oesophagectomy for cancer using the right thoracoscopic approach. Surg Oncol 2:3–11. https://doi.org/10.1016/0960-7404(93)90052-Z - DOI - PubMed

LinkOut - more resources