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CC BY-NC-ND 4.0 · South Asian J Cancer 2021; 10(04): 230-235
DOI: 10.1055/s-0041-1730085
Original Article: Gastrointestinal Cancer

Operative Outcomes of Minimally Invasive Esophagectomy versus Open Esophagectomy for Resectable Esophageal Cancer

Ramachandra Chowdappa
1   Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
,
Anvesh Dharanikota 
1   Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
,
Ravi Arjunan
1   Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
,
Syed Althaf
1   Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
,
Chennagiri S. Premalata
2   Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
,
Namrata Ranganath
3   Department of Anesthesiology and Pain Relief, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India
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Abstract

Background There is a recent rise in the incidence of esophageal carcinoma in India. Surgical resection with or without neoadjuvant chemoradiation is the current treatment modality of choice. Postoperative complications, especially pulmonary complications, affect many patients who undergo open esophagectomy for esophageal cancer. Minimally invasive esophagectomy (MIE) could reduce the pulmonary complications and reduce the postoperative stay.

Methodology We performed a retrospective analysis of prospectively collected data of 114 patients with esophageal cancer in the department of surgical oncology at a tertiary cancer center in South India between January 2019 and March 2020. We included patients with resectable cancer of middle or lower third of the esophagus, and gastroesophageal junction tumors (Siewert I). MIE was performed in 27 patients and 78 patients underwent open esophagectomy (OE). The primary outcome measured was postoperative complications of Clavien–Dindo grade II or higher within 30 days. Other outcomes measured include overall mortality within 30 days, intraoperative complications, operative duration and the length of hospital stay.

Results A postoperative complication rate of 18.5% was noted in the MIE group, compared with 41% in the OE group (p = 0.034). Pulmonary complications were noted in 7.4% in the MIE group compared to 25.6% in the OE group (p = 0.044). Postoperative mortality rates, intraoperative complications, and other nonpulmonary postoperative complications were almost similar with MIE as with open esophagectomy. Although the median operative time was more in the MIE group (260 minutes vs. 180 minutes; p < 0.0001), the median length of hospital stay was shorter in patients undergoing MIE (9 days vs. 12 days; p = 0.0001).

Conclusions We found that MIE resulted in lower incidence of postoperative complications, especially pulmonary complications. Although, MIE was associated with prolonged operative duration, it resulted in shorter hospital stay.

Keywords

minimally invasive esophagectomy - open esophagectomy - operative outcomes - pulmonary complications - esophageal cancer


Publication History

Article published online:
31 December 2021

© 2021. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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