Comparison Of Perioperative Outcomes Following Open Versus Hybrid Minimally Invasive Ivor Lewis Esophagectomy For Esophageal Cancer
Ju Sik Yun, Kook Joo Na, Seok Kim, Sang Yun Song.
Chonnam National University Hwasun Hospital, Hwasun-gun, Jeollanam-do, Korea, Republic of.
There are serveral different approaches for minimally invasive esophagectomy by application of thoracoscpy, laparoscopy, or both with various patient's position and anastomotic techniques. The aim of this study was to assess the impacts of hybrid minimally invasive Ivor Lewis esophagectomy (laparosopy and thoracotomy) for cancer on perioperative outcomes.
This study is a retrospective review of 149 patients undergoing Ivor Lewis esophagectomy for squamous cell carcinoma between October 2006 to September 2016. Patients who received neoadjuvant treatment prior to surgery (n= 22) and have undergone complete minimally invasive procedures (n= 16) were excluded. Clinical characteristics and perioperative outcomes of patients undergoing hybrid esophagectomy (HE, n= 48) were compared with findings in patients undergoing open esophagectomy (OE, n= 63)).
There were 108 males (97.3%) and 3 females (2.7%); mean age was 65.3 ± 8.1 years (range, 45 to 83 years). The two groups were comparable with respect to age, sex, preoperative pulmonary function (FEV1 ratio), clinical stage and location of tumor. There was no significant difference between two groups with regard to operative time and postoperative pain scores. Postoperative complications occured in 17 (35.4%) in HE and 24 (38.1%) in OE (p= 0.772). The in-hospital mortality was 4.2% in HE and 9.5% in OE (p= 0.280). However, HE group had higher immediate postoperative albumin level (3.3 vs 2.9 g/dL, p< 0.001) and shorter hospital stay (13.7 vs 19.5 days, p= 0.008).
Hybrid minimally invasive Ivor Lewis esopagectomy for esophageal cancer showed advantages of better postoperative nutrition status and shorter hospital stay, compared to conventional open approach. Further studies are needed to evaluate the long-term oncologic outcome of this hybrid approach.
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