Evolving changes of minimally invasive esophagectomy: a single-institution experience.

Surgical Endoscopy
Sahil GambhirNinh T Nguyen

Abstract

Initial adoption of minimally invasive esophagectomy (MIE) began in the late 1990s but its surgical technique, perioperative management, and outcome continues to evolve. The aim of this study was to examine the evolving changes in the technique, outcome, and new strategies in management of postoperative leaks after MIE was performed at a single institution over a two-decade period. A retrospective chart review of 75 MIE operations was performed between November 2011 and September 2018 and this was compared to the initial series of 104 MIE operations performed by the same group between 1998 and 2007. Operative technique, outcomes, and management strategies of leaks were compared. There were 65 males (86.7%) with an average age of 61 years. The laparoscopic/thoracoscopic Ivor Lewis esophagectomy became the preferred MIE approach (49% of cases in the initial vs. 95% in the current series). Compared to the initial case series, there was no significant difference in median length of stay (8 vs. 8 days), major complications (12.5% vs. 14.7%, p = 0.68), incidence of leak (9.6% vs. 10.6%, p = 0.82), anastomotic stricture (26% vs. 32.0%, p = 0.38), or in-hospital mortality (2.9% vs. 2.6%, p = 0.47). Management of esophageal leaks has ch...Continue Reading

References

Dec 19, 2008·Annals of Surgery·Ninh T NguyenDavid Hoyt
May 25, 2010·The Annals of Thoracic Surgery·Arjun PennathurJames D Luketich
Sep 10, 2011·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Ninh T NguyenMichael J Stamos
Feb 22, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Smita SihagChristopher R Morse
Jun 7, 2012·Annals of Surgery·James D LuketichKatie S Nason
Oct 15, 2014·Interactive Cardiovascular and Thoracic Surgery·Yusuke TaniyamaNorikaki Ohuchi
Dec 6, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Quan-Xing LiuJi-Gang Dai
Aug 14, 2015·The Tohoku Journal of Experimental Medicine·Kazuo KoyanagiYuji Tachimori

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Citations

Apr 8, 2020·Annals of Gastroenterological Surgery·Soji OzawaTadashi Higuchi
Oct 20, 2020·The American Surgeon·Ellyn A SmithNinh T Nguyen

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