Long-term outcome of open versus hybrid minimally invasive Ivor Lewis oesophagectomy: a propensity score matched study

Rinieri, Philippe; Ouattara, M.; Brioude, Geoffrey; Loundou, Anderson; Lesquen, Henri de; Trousse, Delphine; Doddoli, Christophe; Thomas, Philippe; D’Journo, Xavier Benoît

doi:10.1093/ejcts/ezw273

Cited by 14 publications

(9 citation statements)

References 14 publications

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“…The results preferred hybrid approach in terms of overall postoperative morbidity and especially major pulmonary complications (36). Nevertheless, Rinieri et al point out that the laparoscopic approach can result in a lower number of harvested lymph nodes, although it had no impact on 5-year overall and disease-free survival (37). Therefore MIT should be an approach of choice for esophageal cancer surgery.…”

Section: Operative Proceduresmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) programs for esophagectomy

Rubinkiewicz¹,

Witowski²,

Su³

et al. 2019

J. Thorac. Dis

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A perioperative treatment protocol, enhanced recovery after surgery (ERAS) focuses on accelerating patient recovery. Previous studies confirmed that ERAS decreases surgical trauma and the stress response, which improved outcomes including reduced length of hospital stay (LOS) and decreased postoperative morbidity. While ERAS protocols have been successfully implemented in a variety of surgical disciplines (colorectal, bariatric, orthopedic, and gynecologic surgery), its use in esophageal surgery is still limited. This paper analyzes the feasibility and value of the ERAS protocol for esophageal surgery. Reviewing the literature found that implementation of ERAS resulted in decreased costs, length of stay and pulmonary specific complication reduction, but not overall morbidity. The evidence lacks randomized control trials. Further, the ERAS Society published recommendations for esophageal resection. This opportunity for unification of the protocol would make the studies more comparable and leads to stronger conclusions. Surgery specific items also require further confirmation. Nonetheless, the successful introduction of the ERAS protocol into a wide variety of surgical disciplines provides optimism for ERAS's effectiveness in esophageal surgery.

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Section: Operative Proceduresmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) programs for esophagectomy

Rubinkiewicz¹,

Witowski²,

Su³

et al. 2019

J. Thorac. Dis

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“…The overall pulmonary complications in our study are 8.39% in comparison to 17.1% in minimally invasive esophagectomies, in a meta-analysis of 57 studies [16] . The lymph node retrieval rate is 22.68 ± 9.49 in comparison to 22 ± 10 in a propensity score-matched study comparing open and laparoscopic group by Rinieri et al [17] . The length of ICU stay in our study is 4.68 ± 3.95 days, and length of hospital stay is 13.48 ± 7.43 days, in comparison to 3.6 days and 12 days in a similar stud of minimally invasive ILE by Zonča et al [18] .…”

Section: Discussionmentioning

confidence: 86%

Thoraco-laparoscopic Ivor-Lewis esophagectomy: the most extensive Indian experience

Parthasarathi¹,

Gupta²,

Sabnis³

et al. 2019

MIS

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Aim: The overall incidence of adenocarcinoma is on the rise, mainly in the western population. Minimally invasive thoracolaparoscopic esophagectomy for adenocarcinoma of gastroesophageal junction tumors is being adopted worldwide, albeit with a slower pace. This study is to share our experience and technical modifications over two decades. Methods: This a retrospective data from 2009-2018 at a single center, including all the 143 cases of thoracolaparoscopic Ivor Lewis esophagectomies performed. There were no exclusions. The study objectives were to evaluate postoperative recovery, complications, and pathological completeness. Results: In 11 years, we have performed 532 cases of minimally invasive esophagectomies for both malignant and benign etiologies. Out of which 143 cases were of Ivor Lewis esophagectomy. The mean age of patients was 64.4 ± 10.86 years, and male to female ratio is 3:1. Out of these cases, 139 (97.20%) were performed for malignancy and 4 (2.79%) for benign cases, which include peptic stricture, sigmoid esophagus. The mean operative time is 457.97 ± 79.35 min. The mean blood loss was 138.08 ± 29.3mL. Out of these cases, the hand-sewn anastomosis was performed in 72 (50.34%), circular stapler anastomosis in 46 (32.16%) and, linear stapled anastomosis in 25 (17.48%). The mean lymph node retrieval rate was 22.68 ± 9.49 nodes. The average ICU stay in the postoperative period was 4.68 ± 3.95 days, and overall hospital stay was 13.48 ± 7.43 days. Among malignant cases (139), adenocarcinoma in 121 (87.05%), squamous cell carcinoma in 18 (12.94%). Among these cases T2, lesions in 56 (40.28%), T3 lesions in 77 (55.39%), T4 lesions in 6 (4.31%) The overall complication rate was 12.58% (pneumonia-8.39%, RLN injury in 1.39%, anastomotic leak in 2.09%, chyle leak in 0.69%, anastomotic stricture in 12.58%). 3 (2.09%) cases had re-intervention in the form of combined endoscopic procedures (stenting) and re-thoracoscopic lavage in 3. Overall 30-day mortality in 1 case (0.69%). Conclusion: Thoracolaparoscopic esophagectomy with intrathoracic Ivor Lewis anastomosis is an excellent option for selected patients, in experienced hands.

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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%

“…110 In combination with several case-matched studies, these findings suggest that morbidity may already be reduced by only performing the abdominal phase minimally invasively. 111,112 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. However, the additional value of avoiding an open thoracic phase has not yet properly been investigated, and therefore comparative studies for full versus hybrid MIE are warranted.…”

Section: Minimally Invasive Surgerymentioning

confidence: 99%

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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Long-term outcome of open versus hybrid minimally invasive Ivor Lewis oesophagectomy: a propensity score matched study

Cited by 14 publications

References 14 publications

Enhanced recovery after surgery (ERAS) programs for esophagectomy

Enhanced recovery after surgery (ERAS) programs for esophagectomy

Thoraco-laparoscopic Ivor-Lewis esophagectomy: the most extensive Indian experience

Surgical treatment of esophageal cancer in the era of multimodality management

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