The Contemporary Role of Minimally Invasive Esophagectomy in Esophageal Cancer

Mallipeddi, Mohan K.; Onaitis, Mark W.

doi:10.1007/s11912-013-0374-9

Cited by 19 publications

(15 citation statements)

References 45 publications

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“…Afterwards, a variety of MIE approach procedures were reported with better surgical outcomes, for example, laparoscopic transhiatal esophagectomy (15,16), Ivor-Lewis esophagectomy in laparoscopic and/or laparoscopic technique (17,18), laparoscopic and/or laparoscopic McKewon esophagectomy (14,19,(20)(21)(22). In 1994, Cuschieri reported a new approach of MIE in prone position with satisfactory outcomes, compared to procedures in left lateral decubitus position (23).…”

Section: Discussionmentioning

confidence: 99%

Better perioperative outcomes in thoracoscopic-esophagectomy with two-lung ventilation in semi-prone position

Li¹,

Sun²,

Yang³

et al. 2017

J. Thorac. Dis.

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Background: One-lung ventilation (OLV) anesthesia intubation route is often used in patients undergoing thoracoscopic-esophagectomy in semi-prone position. Recently, the two-lung ventilation (TLV) approach becomes popular. However, limited studies have compared the two ventilation approaches in parallel. Here, we report a single-center, retrospective study of comparing TLV and OLV approach in patients undergoing thoracoscopic-esophagectomy in semi-prone position. Conclusion: This study demonstrated that TLV intubation approach is superior to OLV approach during the thoracoscopic-esophagectomy in semi-prone position. According to this, TLV approach is a technically feasible, convenient and safe anesthesia induction approach for esophageal cancer surgery.

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Section: Discussionmentioning

confidence: 99%

Better perioperative outcomes in thoracoscopic-esophagectomy with two-lung ventilation in semi-prone position

Li¹,

Sun²,

Yang³

et al. 2017

J. Thorac. Dis.

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“…Currently, MIE can be performed through the laparoscopic transhiatal, the laparoscopic-thoracoscopic McKeown, or the laparoscopic-thoracoscopic Ivor Lewis approach [2]. Although there are differences in the specific operative approach, supporters of MIE have cited reduced perioperative morbidity, shortened hospital stay, and improved patient satisfaction when compared with traditional open esophagectomy (OE) [3].…”

mentioning

confidence: 99%

Minimally Invasive Versus Open Esophagectomy for Esophageal Cancer: A Population-Based Analysis

Yerokun

Sun

Yang

et al. 2016

The Annals of Thoracic Surgery

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141

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Background The objective of this study was to evaluate outcomes of minimally invasive approaches to esophagectomy using population-level data. Methods Multivariable regression modeling was used to determine predictors associated with the use of minimally invasive approaches for patients in the National Cancer Data Base who underwent resection of middle and distal clinical T13N03M0 esophageal cancers from 2010 to 2012. Perioperative outcomes and 3-year survival were compared between propensity-matched groups of patients with esophageal cancer who underwent minimally invasive esophagectomy (MIE) or open esophagectomy (OE). A subgroup analysis was performed to evaluate the impact of using robotic-assisted operations as part of the minimally invasive approach. Results Among 4,266 patients included, 1,308 (30.6%) underwent MIE. It was more likely to be used in patients treated at academic (adjusted odds ratio [OR], 10.1; 95% confidence interval [CI], 4.2–33.1) or comprehensive cancer facilities (adjusted OR, 6.4; 95% CI, 2.6–21.1). Compared with propensity-matched patients who underwent OE, patients who underwent MIE had significantly more lymph nodes examined (15 versus 13; p = 0.016) and shorter hospital lengths of stay (10 days versus 11 days; p = 0.046) but similar resection margin positivity, readmission, and 30-day mortality (all p > 0.05). Survival was similar between the matched groups at 3 years for both adenocarcinoma and squamous cell carcinoma (p > 0.05). Compared with MIE without robotic assistance, use of a robotic approach was not associated with any significant differences in perioperative outcomes (p > 0.05). Conclusions The use of minimally invasive techniques to perform esophagectomy for esophageal cancer is associated with modestly improved perioperative outcomes without compromising survival.

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“…To improve patient factors, preoperative conditioning such as promoting cardiovascular fitness by encouraging walking a mile a day and using a spirometer for a month prior to surgery, as well as smoking cessation to decrease the risk for morbidity, is suggested. Using the minimally invasive technique also decreases hospital stay, and allows for early ambulation and participation in physical therapy due to lower pain scores after surgery 7. All medications must be renally dosed, and those with active metabolites that are renally excreted, such as Demerol, must be avoided.…”

Section: Discussionmentioning

confidence: 99%