Laparoscopic transhiatal esophagectomy: outcomes

Tinoco, Renam Catharina; El-Kadre, Luciana; Tinoco, Augusto; Rios, Rodrigo Amaral; Sueth, Daniela M.; Pena, Felipe Montes

doi:10.1007/s00464-007-9267-z

Cited by 11 publications

(2 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 The need to reduce this morbidity has led to the development of minimally invasive techniques for performing each of the 3 types of esophagectomy. 8,9 Owing to the technically demanding nature of this procedure, access to minimally invasive esophagectomy (MIE) has been limited to select specialized centers that have been able to show comparable results. However, such high-volume centers tend to advocate a specific minimally invasive technique, such as Ivor Lewis or transhiatal esophagectomy, reflecting the learning curve and experience of each institution.…”

mentioning

confidence: 99%

The use of a tailored surgical technique for minimally invasive esophagectomy

Javidfar

Bacchetta

Yang

et al. 2012

The Journal of Thoracic and Cardiovascular Surgery

View full text Add to dashboard Cite

Objective: Uncertainty exists among surgeons as to whether minimally invasive esophagectomy (MIE) is a comparable operation to open esophagectomy (OE). The surgical technique and oncologic dissection should not be degraded when using a minimally invasive approach.Methods: We reviewed a single hospital's experience with both OE and MIE. From 2000 to 2010, 257 patients underwent esophagectomy by 1 of 3 surgical techniques: transhiatal, Ivor Lewis, or 3-hole.Results: Of the 257 patients (median age, 67 years; range, 58-74), 92 underwent MIE. Both groups were comparable in terms of gender, age, comorbidities, surgical technique, and induction chemotherapy and radiotherapy. The overall median follow-up was 29.5 months (range, 9.9-61.5). The MIE group had a significantly shorter operative time (MIE vs OE, 330 vs 365 minutes, P ¼ .04), length of stay (MIE vs OE, 9 vs 12 days, P <.01), intensive care unit admission rate (MIE vs OE, 55% vs 81%, P<.01), intensive care unit length of stay (MIE vs OE, 1 vs 2 days, P<.01), and estimated blood loss (MIE vs OE, 100 vs 400 mL, P <.01). More lymph nodes were harvested in the MIE group than in the OE group (17 vs 11 nodes, P<.01). There were insignificant differences in 30-day mortality (MIE vs OE, 2.2% vs 3.0%; P ¼ .93) and overall survival (P ¼ .19), as well as in the rates of all complications, except pneumonia (MIE vs OE, 2% vs 13%; P ¼ .01).Conclusions: A thoracic surgeon can safely tailor the MIE to a patient's anatomy and oncologic demands while maintaining equivalent survival.

show abstract

mentioning

confidence: 99%

The use of a tailored surgical technique for minimally invasive esophagectomy

Javidfar

Bacchetta

Yang

et al. 2012

The Journal of Thoracic and Cardiovascular Surgery

View full text Add to dashboard Cite

show abstract

“…In total 8 studies remained available for analysis, of which 4 were comparative cohort studies [14][15][16][17] and 4 were noncomparative cohort studies. [18][19][20][21] The results of the critical appraisal to assess the methodological quality of the comparative studies are shown in Table 1. None of the included studies performed a prospective calculation of the sample size nor were patients randomized.…”

Section: Eligible Studiesmentioning

confidence: 99%

Current status of laparoscopic transhiatal esophagectomy for esophageal cancer patients: a systematic review of the literature

Parry

Ruurda

Sluis

et al. 2016

Diseases of the Esophagus

View full text Add to dashboard Cite

Minimally invasive techniques in transhiatal esophagectomy (THE) were introduced to reduce morbidity and enhance postoperative recovery. Aim of this study was to systematically review the current status and possible beneficial effects of the minimally invasive approach in THE. A systematic search was performed in PubMed, the Cochrane Library, and Embase to identify English articles published on laparoscopic THE. Comparative cohort studies were included for critical appraisal. Data describing perioperative and oncological outcomes were analyzed. A total of four comparative cohort studies that compared laparoscopic THE (n = 122) with open THE (n = 144) and four noncomparative cohort studies reporting on laparoscopic THE (n = 212) were included in this review. Median blood loss was significantly lower in the laparoscopic group in all studies (100-500 vs. 526-900 mL). Length of hospital stay was also significantly shorter for the laparoscopic approach in all studies (9-13 vs. 12-16 days). One study reported less major postoperative complications after laparoscopic THE (12 vs. 23%), in the other studies no differences were found. Also no differences were found with regard to operating time, postoperative morbidity, radicality, and lymph node retrieval. Based on these pioneer studies, laparoscopic THE was demonstrated to be safe and feasible with evidence of reduced blood loss and shorter hospital stays. However, level 1 evidence is lacking and further research is warranted to confirm these findings and also to evaluate long-term oncologic outcomes.

show abstract