Minimally invasive esophagectomy for esophageal carcinoma: clinical analysis of 160 cases / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the feasibility, safety and clinical application value of minimally invasive esophagectomy (MIE).</p><p><b>METHODS</b>Clinical data of 160 patients undergoing minimally invasive approach in the West China Hospital of Sichuan University between February 2008 and December 2011 were analyzed retrospectively.</p><p><b>RESULTS</b>There were 140 males and 20 females with a mean age of 59.6 years. Approaches to esophagectomy were thoracoscopic and laparoscopic esophagectomy (n=139), thoracoscopic and mediastinoscopic esophagectomy (n=3), laparoscopic-assisted Ivor Lewis resection (n=15), thoraco-laparoscopic Ivor Lewis resection (n=3). The mean operative time was 364 (range 230-780) min and the mean blood loss was 286.2 (range 20 to 4000) ml. The tumor free resection margins (R0) were completely in 152 cases (95.0%). The mean lymph node harvested was 19.4 (range 6-39). There were 11 (6.9%) cases converted to open operation including 9 thoracotomy and 2 laparotomy. The intraoperative complication rate was 11.3% (18/160). The average length of intensive care unit (ICU) stay was 22.1(range 0 to 430) h and the average length of postoperative hospital stay was 13.1 (range 7-93 d). Postoperative complication occurred in 34.4% of patients. The 30-day mortality was 1.2% (2/160) and the overall mortality was 2.5% (4/160).</p><p><b>CONCLUSION</b>MIE is technically feasible and safe for the treatment of esophageal carcinoma, which provides good or even better outcomes than open approach.</p>