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. 2022 Mar 15;17(1):36.
doi: 10.1186/s13019-022-01781-2.

Safety and efficacy of minimally invasive McKeown esophagectomy in 1023 consecutive esophageal cancer patients: a single-center experience

Xiao-Dong Zheng #  1 , Shi-Cong Li #  1 , Chao Lu #  1 , Wei-Ming Zhang  2 , Jian-Bin Hou  2 , Ke-Feng Shi  2 , Peng Zhang  3
Affiliations

Safety and efficacy of minimally invasive McKeown esophagectomy in 1023 consecutive esophageal cancer patients: a single-center experience

Xiao-Dong Zheng et al. J Cardiothorac Surg. .

Abstract

Objective: By analyzing the perioperative, postoperative complications and long-term overall survival time, we summarized the 8-year experience of minimally invasive McKeown esophagectomy for esophageal cancer in a single medical center.

Methods: This retrospective follow-up study included 1023 consecutive patients with esophageal cancer who underwent MIE-McKeown between Mar 2013 and Oct 2020. Relevant variables were collected and evaluated. Overall survival (OS) and disease-free survival (DFS) were analyzed by Kaplan-Meier method.

Results: For 1023 esophageal cancer undergoing MIE-McKeown, the main intraoperative complications were bleeding (3.0%, 31/1023) and tracheal injury (1.7%, 17/1023). There was no death occurred during operation. The conversion rate of thoracoscopy to thoracotomy was 2.2% (22/1023), and laparoscopy to laparotomy was 0.3% (3/1023). The postoperative morbidity of complications was 36.2% (370/1023), of which anastomotic leakage 7.7% (79/1023), pulmonary complication 13.4% (137/1023), chylothorax 2.3% (24/1023), and recurrent laryngeal nerve injury 8.8% (90/1023). The radical resection rate (R0) was 96.0% (982/1023), 30-day mortality was 0.3% (3/1023). For 1000 cases with squamous cell carcinoma, the estimated 3-year and 5-year overall survival was 37.2% and 17.8% respectively. In addition, neoadjuvant chemotherapy offered 3-year disease-free survival rate advantage in advanced stage patients (for stage IV: 7.2% vs. 1.8%).

Conclusions: This retrospective single center study demonstrates that MIE-McKeown procedure is feasible and safe with low perioperative and postoperative complications' morbidity, and acceptable long-term oncologic results.

Keywords: Cancer treatment; Complication; Esophageal cancer; Minimally invasive esophagectomy; Prognosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan–Meier survival curve of patients presenting with esophageal cell carcinoma who received the minimally invasive McKeown esophagectomy, stratified by stage
Fig. 2
Fig. 2
Kaplan–Meier survival curve of patients presenting with esophageal cell carcinoma who received the minimally invasive McKeown esophagectomy, stratified by stage
See this image and copyright information in PMC

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