Minimally invasive (MIE) vs open surgery for cancer of esophagus and GE junction. Long term results

Authors

  • Binay Thakur
  • Di Yonghui
  • Mukti Devkota
  • Paribartan Baral
  • Yogesh Regmi
  • Rajendra Malli
  • Upsana Tiwari

DOI:

https://doi.org/10.3126/jssn.v18i3.15267

Keywords:

Esophageal cancer, Mckeon’s esophagectomy, VATS

Abstract

Introduction: MIE is becoming a preferred approach for cancer of esophagus and GE junction, but its benefits have yet to be confirmed in randomized controlled trials. We performed a retrospective comparison between these two approaches for complications and survival results.

Methods: Patients primarily going for surgery or after neoadjuvant chemo/ chemoradiation were reviewed. MIE varied from totally thoracoscopic and laparoscopic to a hybrid approach. Both MIE and Open approaches were a three, two or one incision procedures.

Results: MIE and open surgery were done in 128 and 293 patients, respectively. The mean basic parameters (referred as MIE/ Open) – age (59/ 57 years), duration of dysphagia (4/ 4 months), weight loss (8/ 9 kg), postoperative stay (13/ 14 days), hospital mortality (3/ 17), anastomotic leak (17/ 32), hoarseness of voice (8/ 16), number of harvested nodes (21/ 22), and R0 resection (122/ 263) did not differ significantly (p = ns). Mean operative time (265/ 240 mins) and intraoperative blood loss (325/ 436 ml) differed significantly (p < 0.05). Postoperative pneumonia was significantly less in MIE group (p<0.001). Median and 5-year overall survival was 33 months and 21% in MIE group; and 27 months and 20% in open group (p = 0.2)

Conclusion: MIE and Open surgery did not differ in major postoperative complications except postoperative pneumonia, which was less in MIE. Both the procedures were similar in achieving R0 resection, median and 5-year overall survival.

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Published

2016-07-25

How to Cite

Thakur, B., Yonghui, D., Devkota, M., Baral, P., Regmi, Y., Malli, R., & Tiwari, U. (2016). Minimally invasive (MIE) vs open surgery for cancer of esophagus and GE junction. Long term results. Journal of Society of Surgeons of Nepal, 18(3), 12. https://doi.org/10.3126/jssn.v18i3.15267

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Abstracts