Journal article
Experience with minimally invasive esophagectomy
Surgical endoscopy, Vol.20(2), pp.298-301
02/2006
DOI: 10.1007/s00464-005-0093-x
PMID: 16362469
Abstract
Minimally invasive esophagectomy (MIE) is an evolving surgical alternative to traditional open esophagectomy. Despite considerable technical challenges, it was hypothesized that MIE could be performed effectively by surgeons experienced in open esophageal resection and advanced laparoscopic surgery. The authors report their experience with 25 patients who underwent MIE for esophageal disease.A multidisciplinary esophageal cancer team evaluated all the patients enrolled in this institutional review board–approved retrospective review study. Over an 18-month period, 25 consecutive patients (22 men and 3 women; mean age, 62 years; range, 48–77 years) with resectable esophageal cancer underwent MIE. Six patients were treated with neoadjuvant chemoradiotherapy. The preoperative diagnoses were adenocarcinoma (64%, n = 16), high-grade dysplasia (20%, n = 5), and squamous cell cancer (16%, n = 4). The outcomes evaluated included operative course, hospital and intensive care unit lengths of stay, pathologic stage, morbidity, and mortality.Two patients required conversion to open esophagectomy. Operative mortality was 4% (n = 1). The mean operative time was 350 min (range, 300–480), and the average blood loss was 200 ml. The patients remained ventilated for a median of 12 h, and the median intensive care unit utilization was 1 day. The median hospital length of stay was 9 days (range, 6–33 days). Major complications occurred in 32% of the patients. The anastomotic leak rate was 12%. Minor pulmonary complications occurred in 32% and atrial fibrillation in 16% of the patients. An anastomotic stricture developed in 24% of all the patients. One patient showed a positive proximal margin in the final pathology results.Minimally invasive esophagectomy is a technically challenging procedure that can be performed safely at the Virginia Piper Cancer Institute. Optimal results require appropriate patient selection and a multidisciplinary team experienced in the management of esophageal cancer.
Details
- Title: Subtitle
- Experience with minimally invasive esophagectomy
- Creators
- G Collins - Abbott Northwestern HospitalE Johnson - Department of Surgery, Virginia Piper Cancer Institute Abbott Northwestern Hospital 800 East 28th Street Minneapolis MN55047 USAT Kroshus - Department of Surgery, Virginia Piper Cancer Institute Abbott Northwestern Hospital 800 East 28th Street Minneapolis MN55047 USAR Ganz - Abbott Northwestern HospitalK Batts - Department of Pathology, Virginia Piper Cancer Institute Abbott Northwestern Hospital 800 East 28th Street Minneapolis MN55047 USAJ Seng - Abbott Northwestern HospitalO Nwaneri - Department of Medicine, Virginia Piper Cancer Institute Abbott Northwestern Hospital 800 East 28th Street Minneapolis MN 55047 USAD Dunn - Department of Surgery, Virginia Piper Cancer Institute Abbott Northwestern Hospital 800 East 28th Street Minneapolis MN55047 USA
- Resource Type
- Journal article
- Publication Details
- Surgical endoscopy, Vol.20(2), pp.298-301
- Publisher
- Springer-Verlag
- DOI
- 10.1007/s00464-005-0093-x
- PMID
- 16362469
- ISSN
- 0930-2794
- eISSN
- 1432-2218
- Language
- English
- Date published
- 02/2006
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984094536702771
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