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Comparison of the outcomes between open thoracotomy versus minimally invasive thoracoscopic esophagectomy in esophageal cancer
reza bagheri, Sr.1, Seyed ziaollah haghi1, Nazanin Hazrati1, Mahdi Seilanian Toussi2, Mitra Ahadi1.
1Cardio-Thoracic Surgery & Transplant Research Center, Emam Reza hospital, Mashhad University of Medical Sciences, mashhad, Iran, Islamic Republic of, 2Cancer Research Center, School of Medicine, Mashhad University of Medical Sciences, mashhad, Iran, Islamic Republic of.
OBJECTIVE: The first choice for treatment of esophageal cancer is surgery. There is Controversy in selection of the best surgical approach. We compared Minimal invasive versus open esophagectomy in short-term outcomes and preoperative complications.
METHODS: We performed a clinical trial between 2011-2013 in Ghaem hospital (Mashhad- Iran). 61 patients underwent minimal invasive esophagectomy (MIE) or open surgery (OE). The parameters included age, sex, site of lesion, amount of bleeding, duration of surgery, rate of conversion to open surgery, postoperative morbidity, duration of hospitalization and mortality.
RESULTS: 61 patients (60.7% male & 39.3% female), were enrolled in this study with the mean age of 62.39±11.91 years. There was no significant statistical difference in site of lesion and stage of tumor. (Site of lesion; p=0.014, stage of tumor; p=0.108) There was not statistical difference in blood transfusion between two groups (p=0.981) In post operative complications, we found 1 ( 1.6%) fistula in MIE group and 2 pleural ( 3.3%) effusion and 1 (1.6%) wound infection in open group. There was no significant differ between two groups in post operative complications. Surgery duration took more times in MIE group than OE (170.68 versus 150.47min; p<0.001). There was 1 patient in MIE group that convert to open approach. Hospitalization duration was significantly longer in open group (in MIE group 7.68 and in open group 9.13 days; p<0.001). We didn't have any mortality in our cases.
CONCLUSIONS: Our evidences show the MIE result is comparable with OE and improve short-term outcomes.
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