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

• Published in: Journal of Society of Surgeons of Nepal 2016-07, Vol.18 (3), p.12
• Main Authors: Thakur, Binay, Yonghui, Di, Devkota, Mukti, Baral, Paribartan, Regmi, Yogesh, Malli, Rajendra, Tiwari, Upsana
• Format: Article
• Language: English
• Subjects: Esophageal cancer; Mckeon’s esophagectomy; VATS
• ISSN: 1815-3984; 2392-4772
• DOI: 10.3126/jssn.v18i3.15267

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