Laparoscopic Gastric Mobilization Reduces Postoperative Mortality After Esophageal Cancer Surgery

Messager, Mathieu; Pasquer, Arnaud; Duhamel, Alain; Caranhac, Gilbert; Piessen, Guillaume; Mariette, C.

doi:10.1097/sla.0000000000001470

Cited by 68 publications

(44 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After MIE was proven to be a feasible and safe procedure over the past decade, we introduced this technique at our institution [41516]. In a case–control study of the first 62 MIE patients, we found that implementation of this approach caused no difficulties [12].…”

Section: Discussionmentioning

confidence: 99%

Morbidity in open versus minimally invasive hybrid esophagectomy (MIOMIE)

et al. 2018

View full text Add to dashboard Cite

SummaryBackgroundThe minimally invasive esophagectomy (MIE) for esophageal cancer was introduced assuming a reduction of morbidity and operation time. After implementation of MIE at our institution, a randomized controlled trial was designed.MethodsThis is a prospective randomized controlled study comparing open (OE) and laparoscopic gastric tube (MIE) formation in Ivor Lewis esophagectomy. Primary endpoints were morbidity and 30-day mortality. Secondary endpoints included the duration of intensive care unit stay, length of hospital stay, operative time as well as relapse-free and overall survival.ResultsTwenty patients (76.9%) were male, median age was 63 years (40–77). Median operation time was 290 (215–385) minutes in OE and 292.5 (200–450) minutes in MIE group, p = 0.421. Major complications occurred in 4 (33.3%) patients in the OE group and in 6 (35.7%) patients in the MIE group. Anastomotic leakage was seen in 2 (16.6%) and 3 (21.4%) patients, respectively (OR 1.364; CI = 0.188–9.912; p = 0.759). Due to an alarming number of consecutive anastomotic leakages, the trial was stopped after inclusion of 26 patients. Median follow-up was 41.5 (1–62.6) months. 5‑year survival rate was 50%. Thirty-eight percent developed recurrence of disease in the study period. There was no significant difference in overall and relapse-free survival regarding the type of surgery.ConclusionThis study shows that hybrid MIE is a feasible alternative for esophageal resection. Morbidity, mortality, and oncological long-term results were equal in both groups, but the interpretation has to be done carefully due to premature termination of the trial. Interrupting a trial because of patient benefit should not be a reason to discard results but rather to improve technical aspects and strive for novel studies.

show abstract

Section: Discussionmentioning

confidence: 99%

Morbidity in open versus minimally invasive hybrid esophagectomy (MIOMIE)

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Briez et al reported that the prevalence of major pulmonary complications was significantly lower in the laparoscopic hybrid MIE group than in the open group (15.7% vs. 42.9%, respectively); the same was true for overall morbidity (35.7% vs. 59.3%, respectively) and in-hospital mortality (1.4% vs. 7.1%, respectively), with similar 2-year survival rates between the two groups (21). In a French nationwide study of approximately 3,000 patients, Messager et al compared laparoscopic gastric mobilization with open surgery; they found that the 30-day postoperative mortality was significantly lower in the hybrid (laparoscopic) group even after propensity score matching (3.3% vs. 5.9%), although they did not mention morbidity (22). More recently, Bjelovic et al confirmed some benefits of hybrid MIE as previously described and also reported that a greater number of lymph nodes were harvested from patients who underwent hybrid MIE using laparoscopy than from those who underwent open surgery (31.9 vs. 26.3, respectively) (23).…”

Section: Discussionmentioning

confidence: 99%

Comparison of perioperative outcomes following hybrid minimally invasive versus open Ivor Lewis esophagectomy for esophageal cancer

Yun¹,

Na²,

Song³

et al. 2018

J. Thorac. Dis

View full text Add to dashboard Cite

Background: The outcomes of various minimally invasive esophagectomy (MIE) procedures for esophageal cancer have been reported; however, those of the hybrid approach are lacking. This study aimed to assess the impacts of hybrid minimally invasive Ivor Lewis esophagectomy (HIL, laparoscopy and right thoracotomy) for esophageal cancer on perioperative outcomes compared with the open approach. Methods: This was a retrospective study of 153 patients who underwent Ivor Lewis esophagectomy for squamous cell carcinoma between January 2008 and December 2016. Patients who received neoadjuvant treatment prior to surgery (n=22) and underwent complete minimally invasive procedures (n=16) were excluded. Clinical characteristics and perioperative outcomes of patients who underwent HIL (n=53) were compared with findings in patients who underwent open Ivor Lewis esophagectomy (OIL, n=62). Results: There were 112 men (97.4%) and 3 women (2.6%) with a median age of 66 years (range, 45-83 years). The HIL and OIL groups were comparable with respect to age, sex, preoperative pulmonary function, location of the tumor, and preoperative laboratory findings. There was no significant difference between the two groups regarding surgical data, except for pyloric management. Postoperative complications occurred in 17 (32.1%) and 23 (37.1%) patients in the HIL and OIL groups, respectively (P=0.573); in-hospital mortality rates were 3.8% and 8.1%, respectively (P=0.337). HIL group patients had higher albumin (3.3 vs. 2.9 g/dL; P<0.001) and lower C-reactive protein (6.4 vs. 8.1 mg/L; P<0.001) postoperatively. The length of hospital stay was shorter in the HIL group (13.5 vs. 19.2 days; P=0.002). Conclusions: Compared with the conventional open approach, HIL for esophageal cancer showed better postoperative nutritional and inflammatory status, resulting in shorter hospital stays. However, further studies are required to evaluate the long-term oncologic outcomes of this hybrid approach.

show abstract

“…Oshikiri et al reported that HALS had advantages in terms of less-restrictive ventilatory improvement, fewer subsequent pulmonary complications and less blood loss [8]. In French nationwide study, laparoscopic gastric mobilization in esophagectomy is significantly reduced the postoperative mortality than open gastric mobilization [23]. Usually, laparoscopic procedure related to less trauma and low blood loss in spite of longer operation time.…”

Section: Discussionmentioning

confidence: 99%

Short Term Operative Outcomes of Laparoscopic Gastric Mobilization in Esophagectomy for Esophageal Cancer: Comparison with Hand Assisted Technique

Takemura¹,

Takii²,

Kaibe³

et al. 2016

View full text Add to dashboard Cite

Objective: This study evaluated the safety and operative utilities of the laparoscopic gastric mobilization compared with hand-assisted laparoscopic gastric mobilization. Patients and Methods: From April 2010 to November 2015, 125 patients with esophageal cancer have been performed laparoscopic mobilization; 33 under hand-assisted laparoscopic gastric mobilization (HLG group) and 92 under laparoscopic gastric mobilization without hand-assisted technique (LG group). Preoperative data and surgical outcomes of 2 groups were compared. Results: Preoperative data were not significantly different except for BMI. Operation time in abdominal procedure of LG group is significantly longer than HLG group (P < 0.0001). Otherwise, the blood loss and number of dissected nodes of abdominal procedure was not significantly different in two groups. The perioperative blood transfusions were needed in 7 cases (21.2%) in HLG group and 25 (27.1%) in LG group. The postoperative complications and mortality within 30 days after surgery were not significantly different in two groups. The length of hospital stay was 29 days in HLG group and 31 days in HG group, respectively. Conclusions: Our results suggested that laparoscopic gastric mobilization was safe technique and the short-term operative outcomes were comparable with that of hand-assisted laparoscopic mobilization.

show abstract

Laparoscopic Gastric Mobilization Reduces Postoperative Mortality After Esophageal Cancer Surgery

Abstract: This all-inclusive nationwide study strongly suggests that POM is significantly reduced after LGM for EC. This is high valuable evidence that helps decision making regarding the optimal approach for EC surgery.

Cited by 68 publications

References 25 publications

Morbidity in open versus minimally invasive hybrid esophagectomy (MIOMIE)

Morbidity in open versus minimally invasive hybrid esophagectomy (MIOMIE)

Comparison of perioperative outcomes following hybrid minimally invasive versus open Ivor Lewis esophagectomy for esophageal cancer

Short Term Operative Outcomes of Laparoscopic Gastric Mobilization in Esophagectomy for Esophageal Cancer: Comparison with Hand Assisted Technique

Contact Info

Product

Resources

About