Minimally invasive Ivor-Lewis oesophagectomy is a feasible and safe approach for patients with oesophageal cancer

ANZ J Surg. 2016 Apr;86(4):274-9. doi: 10.1111/ans.13161. Epub 2015 May 12.

Abstract

Background: Minimally invasive approaches are increasingly being used in oesophagectomy. The aim of this study was to compare the short-term clinical outcomes of the minimally invasive Ivor-Lewis oesophagectomy (MIILE) technique with those of the open Ivor-Lewis oesophagectomy (OILE) technique.

Methods: We identified 131 patients who underwent MIILE combined with thoracoscopy and laparoscopy. These patients were compared with 248 patients who underwent OILE between January 2012 and December 2013.

Results: MIILE and OILE produced similar post-operative hospital mortality (MIILE 2.3 versus OILE 2%; P = 1.000). The MIILE approach was associated with a significant decrease in the time until chest drain removal (MIILE 9.07 ± 5.075 days versus OILE 11.26 ± 6.989 days; P = 0.002) and post-operative length of stay (MIILE 10.89 ± 4.976 days versus OILE 12.83 ± 6.921 days; P = 0.002). Pneumonia was the most common complication in both groups. MIILE patients exhibited a lower incidence of post-operative pneumonia (MIILE 17.6% versus OILE 28.2%; P = 0.024) compared with OILE. The survival rate did not significantly differ between the MIILE and OILE groups (1-year survival rates: MIILE 86 versus OILE 88.2%; P = 0.537).

Conclusions: In this study, we demonstrate that MIILE is a feasible and safe approach for patients with middle or lower oesophageal cancer.

Keywords: minimally invasive surgery; oesophageal cancer; oesophagectomy.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / methods*
  • Esophagectomy / mortality
  • Female
  • Humans
  • Laparoscopy / methods*
  • Laparoscopy / mortality
  • Length of Stay
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods*
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Survival Analysis
  • Thoracoscopy / methods*
  • Thoracoscopy / mortality
  • Treatment Outcome