Impact of unplanned events on early postoperative results of minimally invasive esophagectomy

Thoracic Cancer
Xu-feng GuoZhigang Li

Abstract

Minimally invasive esophagectomy (MIE) is increasingly performed worldwide. Unplanned events during thoracoscopy or laparoscopy can jeopardize the procedure, sometimes necessitating conversion to open surgery. The aim of this study was to evaluate the impact of unplanned events on early postoperative outcomes after MIE. A consecutive group of 303 patients who underwent MIE between January 2011 and December 2015 were reviewed. The patients were allocated to two groups comprising those with (G-UPE, 85 patients) and without unplanned events (G-Regular, 218 patients). Unplanned events, defined as events that clearly changed or prolonged the procedure included intraoperative bleeding, chest and/or peritoneal adhesions, tumor invasion (sT4a + T4b), non-radical resection (R2 resection), and conversion for any reason. Differences in postoperative complications between the groups were analyzed. The most common unplanned events were pleural and/or peritoneal adhesions (28/89, 31.5%), followed by intraoperative discovery of tumor invasion (sT4a + T4b, 25/89, 28.1%). There were significant differences in the incidence of respiratory (57.6% vs. 8.3%) and nervous system complications (10.6% vs. 2.7%), postoperative infection (32.9% vs. 5.0%)...Continue Reading

References

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