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

Autor:	Chowdappa R; Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India., Dharanikota A; Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India., Arjunan R; Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India., Althaf S; Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India., Premalata CS; Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India., Ranganath N; Department of Anesthesiology and Pain Relief, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, India.
Jazyk:	angličtina
Zdroj:	South Asian journal of cancer [South Asian J Cancer] 2021 Dec 31; Vol. 10 (4), pp. 230-235. Date of Electronic Publication: 2021 Dec 31 (Print Publication: 2021).
DOI:	10.1055/s-0041-1730085
Abstrakt:	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. Competing Interests: Conflicts of Interest None declared. Ethics Approval This research study was conducted retrospectively from data obtained for clinical purposes. We consulted extensively with the institutional review board of Kidwai Memorial Institute of Oncology, who determined that our study did not need ethical approval. Consent Informed consent was obtained from all individual participants included in the study. Contribution Details RC, RA and SA were the primary operating surgeons in this study. CSP has evaluated all the pathology specimens. NR was the primary anesthesiologist for all the cases. RC and AD have done literature search and were involved in designing the study and in manuscript preparation. Data acquisition, data analysis, and statistical analysis were done by AD. All the authors were involved in editing and reviewing the manuscript. Funding This study did not receive any specific grant or funding. (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/).)
Databáze:	MEDLINE
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