Background:Open and laparoscopic trans-hiatal esophagectomy has been successfully
performed in the treatment of megaesophagus. However, there are no
randomized studies to differentiate them in their results.
Aim:To compare the results of minimally invasive laparoscopic esophagectomy
(EMIL) vs. open trans-hiatal esophagectomy (ETHA) in advanced megaesophagus.
Method:A total of 30 patients were randomized, 15 of them in each group - EMIL and
ETHA. The studied variables were dysphagia score before and after the
operation at 24-months follow-up; pain score in the immediate postoperative
period and at hospital discharge; complications of the procedure, comparing
each group. Were also studied: surgical time in minutes, transfusion of
blood products, length of hospital stay, mortality and follow-up time.
Results:ETHA group comprised eight men and seven women; in the EMIL group, four women
and 11 men. The median age in the ETHA group was 47.2 (29-68) years, and in
the EMIL group of 44.13 (20-67) years. Mean follow-up time was 33 months,
with one death in each group, both by fatal aspiration. There was no
statistically significant difference between the EMIL vs. ETHA scores for
dysphagia, pain and in-hospital complications. The same was true for
surgical time, transfusion of blood products and hospital stay.
Conclusion:There was no difference between EMIL and ETHA in all the studied variables,
thus allowing them to be considered equivalent.