Comparison of Short-term Outcome of Thoracoscopic-Laparoscopic Esophagectomy Versus Transhiatal Esophagectomy for Resectable Esophageal Cancer

Abstract

Background: Esophagectomy is performed in all patients with resectable esophageal cancer. Transthoracic-Laparoscopic Esophagectomy (TLE) is a minimally invasive method and considered to be the most appropriate method. In this study, we aim to evaluate and compare the perioperative outcome, and 1-year overall survival of TLE and Transhiatal Esophagectomy (THE) approaches. Methods: In this retrospective study, we reviewed the medical records of 108 patients with esophageal cancer undergoing TLE (n=44) or THE (n=64) between 2015 and 2018. The patients were followed for one year. The intraoperative and postoperative findings, as well as 1-year overall-survival, were compared between the two groups. Results: TLE compared to THE had a longer surgery duration (278.63±33.28 vs 223.28±33.99 min, P=0.001), a higher number of dissected lymph nodes (15.06±2.95 vs 10.21±2.58, P=0.001), less blood loss (345.45±178.76 vs 585.15±294.75 mL, P<0.001), and need for transfusion (20.5% vs 45.3%, P=0.006) during surgery as well as lower ICU stay (2.59±0.77 vs 3.90±0.83 days, P<0.001) and ward stay (8.77±0.96 vs 11.42±1.71 days, P<0.001). THE had somewhat higher complication than TLE, but with no significant differences. Conclusion: TLE had a similar rate of complication to THE approach, but with lower blood loss and lower ICU and hospital stay, it is a more appropriate method for esophagectomy.