Variation in the Standard of Minimally Invasive Esophagectomy for Cancer—Systematic Review

Minimally invasive esophagectomy (MIE) has been increasingly performed to treat esophageal cancer. Studies published between 1990 and 2012 that described the use of MIE for cancer in at least 50 patients were included for systematic review. The literature search retrieved 34 publications comprising...

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Bibliographic Details
Published in:Seminars in thoracic and cardiovascular surgery 2012, Vol.24 (3), p.176-187
Main Authors: Hanna, George B., MBChB, PhD, FRCS, Arya, Shobhit, BSc, MBBS, MRCS, Markar, Sheraz R., MRCS, MSc, MA
Format: Article
Language:English
Subjects:
Cardiothoracic Surgery
Consensus
Esophageal Neoplasms - mortality
Esophageal Neoplasms - pathology
Esophageal Neoplasms - surgery
esophagectomy
Esophagectomy - adverse effects
Esophagectomy - methods
Esophagectomy - mortality
Esophagectomy - standards
Guideline Adherence - standards
Humans
laparoscopic
Laparoscopy - adverse effects
Laparoscopy - mortality
Laparoscopy - standards
Lymph Node Excision - standards
minimally invasive esophagectomy
operating technique
Postoperative Complications - etiology
Practice Guidelines as Topic - standards
Practice Patterns, Physicians' - standards
Standard of Care - standards
Survival Analysis
Time Factors
Treatment Outcome
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Summary:Minimally invasive esophagectomy (MIE) has been increasingly performed to treat esophageal cancer. Studies published between 1990 and 2012 that described the use of MIE for cancer in at least 50 patients were included for systematic review. The literature search retrieved 34 publications comprising 18 case series, 15 comparative studies, and 1 randomized control trial. Results revealed a wide variability in surgical techniques and perioperative outcomes with a lack of standardized definitions of postoperative complications. In most studies, radical formal lymphadenectomy was not performed and the lymph node harvest fell below the minimum number recommended to achieve survival benefits. There is a need to reach a consensus regarding surgical approaches in MIE, the definition of postoperative complications and the extent of lymphadenectomy before embarking on further randomized controlled trials comparing MIE vs. open approach.
ISSN:1043-0679
1532-9488
DOI:10.1053/j.semtcvs.2012.10.004