Minimally invasive esophagectomy for cancer: Single center experience after 44 consecutive cases
2015
Introduction. At the Department of Minimally Invasive Upper Digestive Surgery
of the Hospital for Digestive Surgery in Belgrade, hybrid minimally invasive
esophagectomy (hMIE) has been a standard of care for patients with resectable
esophageal cancer since 2009. As a next and final step in the change
management, from January 2015 we utilized total minimally invasive
esophagectomy (tMIE) as a standard of care. Objective. The aim of the study
was to report initial experiences in hMIE (laparoscopic approach) for cancer
and analyze surgical technique, major morbidity and 30-day mortality.
Methods. A retrospective cohort study included 44 patients who underwent
elective hMIE for esophageal cancer at the Department for Minimally Invasive
Upper Digestive Surgery, Hospital for Digestive Surgery, Clinical Center of
Serbia in Belgrade from April 2009 to December 2014. Results. There were 16
(36%) middle thoracic esophagus tumors and 28 (64%) tumors of distal thoracic
esophagus. Mean duration of the operation was 319 minutes (approximately five
hours and 20 minutes). The average blood loss was 173.6 ml. A total of 12
(27%) of patients had postoperative complications and mean intensive care
unit stay was 2.8 days. Mean hospital stay after surgery was 16 days. The
average number of harvested lymph nodes during surgery was 31.9. The overall
30-day mortality rate within 30 days after surgery was 2%. Conclusion. As
long as MIE is an oncological equivalent to open esophagectomy (OE), better
relation between cost savings and potentially increased effectiveness will
make MIE the preferred approach in high-volume esophageal centers that are
experienced in minimally invasive procedures.
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