Hybrid minimally invasive esophagectomy vs. open esophagectomy: a matched case analysis in 120 patients

Glatz, Torben; Marjanović, Goran; Kulemann, Birte; Sick, Olivia; Hopt, Ulrich T.; Hoeppner, Jens

doi:10.1007/s00423-017-1550-4

Cited by 49 publications

(57 citation statements)

References 26 publications

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“…Given such concerns, we decided to perform hybrid MIE using thoracoscope. Compared with the study by Glatz and colleagues, who used hybrid MIE with laparoscope, our study showed a greater number of harvested lymph node and a notably lower number of pulmonary complications (17).…”

Section: Discussioncontrasting

confidence: 73%

Clinical outcomes of video-assisted thoracoscopic surgery esophagectomy for esophageal cancer: a propensity score-matched analysis

et al. 2017

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Results: Matching based on propensity scores produced 42 patients in each group for the analysis.After propensity matching, there were only two operative mortalities in the OE group, and both died of postoperative pneumonia. The overall incidence of postoperative complications was 38.1% (16 of 42) and 57.1% (24 of 42) in the VE group and in the OE group, respectively (P=0.088). The incidence of pulmonary complications was lower in the VE group than in the OE group (9.5% vs. 40.5%, P=0.004). The 2-year overall survival and disease-free survival were not different between the two groups (74.4% and 69.5% in the VE group, 69.5% and 69.8% in the OE group, P=0.865 and P=0.513, respectively). Conclusions:In select patients, superior short-term surgical results and equal oncological outcomes were achieved with VE compared with OE.

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Section: Discussioncontrasting

confidence: 73%

Clinical outcomes of video-assisted thoracoscopic surgery esophagectomy for esophageal cancer: a propensity score-matched analysis

et al. 2017

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“…The results favored the hybrid procedure, with a lower complication rate (36% versus 64%, P < 0.001) and a trend toward a better 3‐year survival rate (67% versus 55%, P = 0.05). A retrospective study from Germany also showed a reduction in pulmonary morbidity, blood loss, and a shortening of hospital stay (14 versus 18 days, P = 0.002) in the hybrid group of 60 patients …”

Section: Minimally Invasive Techniquesmentioning

confidence: 90%

Early esophageal cancer: the significance of surgery, endoscopy, and chemoradiation

Mönig

Chevallay

Niclauss

et al. 2018

Annals of the New York Academy of Sciences

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Early carcinomas of the esophagus are histologically classified as adenocarcinoma or squamous cell carcinoma and microscopically subdivided into mucosal and submucosal carcinomas depending on infiltration depth. The prevalence of lymph node metastasis in mucosal carcinoma remains low. However, lymph node metastases arise frequently from tumors with submucosal infiltration, with increasing prevalence in the deeper submucosal sublayers. According to current German guidelines, endoscopic resection is the recommended treatment in mucosal adenocarcinoma without histologic risk factors (lymphatic invasion 1, vascular invasion 1, >grade 2, R1-margin). In superficial submucosal infiltration without histologic risk factors, endoscopic resection can be considered. In squamous cell carcinoma, endoscopic resection is indicated up to middle layer mucosal carcinoma. Beyond these criteria, surgical resection should be considered. The gold standard is a subtotal transthoracic esophagectomy with two-field lymphadenectomy. Total esophagectomy is performed in cervical esophageal carcinoma and transhiatal extended gastrectomy in carcinoma of the cardia. Minimally invasive procedures show good oncologic results and reduce the morbidity of radical esophagectomy. Reduced morbidity might be an argument for surgical resection in borderline cases between endoscopic and surgical resection. In early squamous cell cancer, the combination of endoscopic resection and adjuvant chemoradiotherapy is a therapeutic option with promising results.

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“…Although the full results have not been made available, major pulmonary complications were reported to be significantly less frequent in the hybrid group (30.1% versus 17.7%) in a recently published abstract by the American Society of Clinical Oncology . In combination with several case‐matched studies, these findings suggest that morbidity may already be reduced by only performing the abdominal phase minimally invasively . In this light, hybrid esophagectomy might be an option for surgeons in low‐volume centers who would face challenges in completing their thoracoscopic learning phase owing to insufficient caseload.…”

Section: Minimally Invasive Surgerymentioning

confidence: 84%

Surgical treatment of esophageal cancer in the era of multimodality management

Borggreve

Kingma

Домрачев

et al. 2018

Annals of the New York Academy of Sciences

110

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Over the last decades, the treatment of resectable esophageal cancer has evolved into a multidisciplinary process in which all players are essential for treatment to be successful. Medical oncologists and radiation oncologists have been increasingly involved since the implementation of neoadjuvant therapy, which has been shown to improve survival. Although esophagectomy is still considered the cornerstone of curative treatment for locally advanced esophageal cancer, it remains associated with considerable postoperative morbidity, despite promising results of minimally invasive techniques. In this light, both physical status and response to neoadjuvant therapy may be important factors for selecting patients who will benefit from surgery. Furthermore, it is important to optimize the entire perioperative trajectory: from the initial outpatient clinic visit to postoperative discharge. Enhanced recovery after surgery is increasingly recognized for esophagectomy and emphasizes perioperative aspects, such as nutrition, physiotherapy, and pain management. To date, several facets of esophageal cancer treatment remain topics of debate, such as the preferred neoadjuvant treatment, anastomotic technique, extent of lymphadenectomy, organization of postoperative care, and the role of surgery beyond locally advanced disease. Here, we describe the current and future perspectives in the surgical treatment of patients with esophageal cancer in the context of the available literature.

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Hybrid minimally invasive esophagectomy vs. open esophagectomy: a matched case analysis in 120 patients

Cited by 49 publications

References 26 publications

Clinical outcomes of video-assisted thoracoscopic surgery esophagectomy for esophageal cancer: a propensity score-matched analysis

Clinical outcomes of video-assisted thoracoscopic surgery esophagectomy for esophageal cancer: a propensity score-matched analysis

Early esophageal cancer: the significance of surgery, endoscopy, and chemoradiation

Surgical treatment of esophageal cancer in the era of multimodality management

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