Short-term outcomes of minimally invasive Ivor Lewis esophagectomy for locally advanced esophageal cancer / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To describe the technique for minimally invasive Ivor Lewis esophagectomy (MIILE) and to evaluate the feasibility, safety and the short-term clinical outcomes of this approach.</p><p><b>METHODS</b>The clinical data of 309 patients with locally advanced esophageal cancer who received Ivor Lewis esophagectomy between October 2011 and October 2013 was analyzed retrospectively. Of those 309 patients, 112 underwent MIILE and 197 underwent open Ivor Lewis esophagectomy (OILE). The clinicopathologic factors, operational factors and postoperative complications of the two groups were compared by t test and χ² test.</p><p><b>RESULTS</b>The two groups were similar in terms of gender, age, American Society of Anesthesiologists grade, tumor location, preoperative staging and incidence of comorbidities (P>0.05). The MIILE approach was associated with a significant decrease in surgical blood loss ((186 ± 45) ml vs. (198 ± 47) ml, t=2.086, P=0.039), chest tube duration ((9 ± 5) days vs. (11 ± 6) days, t=2.760, P=0.005) and postoperative stay ((12 ± 6) days vs. (14 ± 7) days, t=2.932, P=0.005) relative to the OILE approach. There was no significant difference between the two groups in the number of total lymph nodes dissected or the stations of the total lymph nodes dissected (P>0.05). The postoperative in-hospital mortality and total morbidity did not differ between the two groups (P>0.05). The MIILE approach was associated with significantly fewer wound infections than the OILE approach (0 vs.4.6%, P=0.029).</p><p><b>CONCLUSION</b>Our MIILE technique for locally advanced esophageal cancer can be safely and effectively performed for intrathoracic anastomosis during esophageal surgeries with favorable early outcomes.</p>