Thoracoscopy in prone position with two-lung ventilation compared to conventional thoracotomy during Ivor Lewis procedure: a multicenter case–control study

Souche, Régis; Nayeri, Mihane; Chati, R.; Huet, Emmanuel; Donici, Ion; Tuech, Jean‐Jacques; Borie, F.; Prudhomme, Michel; Jaber, Samir; Fabre, Jean‐Michel

doi:10.1007/s00464-019-06742-w

Cited by 25 publications

(13 citation statements)

References 33 publications

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“…Our results are also consistent with those presented by Souche et al. ( 9 ), in which the major postoperative pulmonary complications were significantly lower in the minimally invasive oesophagectomy group compared with a hybrid surgery group. However, we had a sample size of approximately twice as many patients.…”

Section: Discussionsupporting

confidence: 93%

“…In the unmatched dataset, we found that TILO was associated with less postoperative pneumonia (15.2 vs 25.0%; P = 0.038), and pleural effusion (4.3 vs 14.1%; P = 0.005) than the HILO group ( Table 2 ). Furthermore, TILO was associated with shorter chest drainage than the HILO group (median(IQR) 8 ( 6 – 9 ) vs 8 (7–10.5) days; P = 0.003). The anastomotic leak rates were not significantly different between TILO and HILO (7.2% vs 6.4%, P = 0.772).…”

Section: Resultsmentioning

confidence: 95%

“…have found that the long-term survival after minimally invasive oesophagectomy compares well with open procedures and might even be better ( 7 ). However, considering the choice between TILO and HILO, no consensus has been reached, with only two retrospective studies with small sample sizes concluding that there was no difference in short-term outcomes between the two groups ( 8 , 9 ). There is also limited evidence on long-term patient survival for these procedures.…”

Section: Introductionmentioning

confidence: 99%

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Short- and Long-Term Outcomes of Totally Versus Hybrid Minimally Invasive Ivor Lewis Oesophagectomy for Oesophageal Cancer: A Propensity Score-Matched Analysis

Zhang²,

Yang³

et al. 2022

Front. Oncol.

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BackgroundFew objective studies have compared totally minimally invasive Ivor Lewis oesophagectomy with hybrid procedure. Here we investigated whether the choice between totally and hybrid minimally invasive Ivor Lewis oesophagectomy influenced short-term outcomes and long-term patient survival.MethodsPatients who underwent totally or hybrid minimally invasive Ivor Lewis oesophagectomy between January 2014 and December 2017 were propensity score matched in a 1:1 ratio. The short- and long-term outcomes between the two groups were compared before and after matching.ResultsOf 138 totally and 156 hybrid minimally invasive oesophagectomy patients were eligible, 104 patients from each group were propensity score matched. Totally minimally invasive oesophagectomy was associated significantly with less blood loss (median(IQR) 100(60–150) vs 120(120–200) ml respectively; P < 0.001), pneumonia (13.5 vs 25.0%; P = 0.035), pleural effusion (3.8 vs 13.5%; P = 0.014), and chest drainage (7.5(6–9) vs 8(7–9) days; P = 0.009) than hybrid procedure. There was no significant difference in 3-year overall survival rate and 3-year disease-free survival rate between the two group.ConclusionsTotally minimally invasive Ivor Lewis oesophagectomy may improve short-term outcomes and specifically reduce the incidence of pulmonary complications compared with hybrid procedure. The long-term overall survival and disease-free survival rates between the two groups were similar.

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Section: Discussionsupporting

confidence: 93%

Section: Resultsmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Short- and Long-Term Outcomes of Totally Versus Hybrid Minimally Invasive Ivor Lewis Oesophagectomy for Oesophageal Cancer: A Propensity Score-Matched Analysis

Zhang²,

Yang³

et al. 2022

Front. Oncol.

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“…To date, no randomized trial has compared the hybrid laparoscopic route to the totally minimally invasive route. Indeed, several retrospective studies have shown an increase in the rate of anastomotic fistula in the thoracoscopy group [ 21 ]. A precise study of the advantage of the thoracoscopic route and a reliable and reproducible technique are essential.…”

Section: Surgical Trendsmentioning

confidence: 99%

New Trends in Esophageal Cancer Management

Gronnier

Collet

2021

Cancers

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“…Management of anastomotic leaks after esophagectomy and gastric pull-up (MIE) being the most common (1). Other less frequently performed operations such as prone esophagectomy with two-lung ventilation and mediastinoscopic esophagectomies also have been described in the literature (2,3). Regardless of surgical approach, esophagectomy is associated with high overall morbidity and significant mortality rates.…”

Section: Review Articlementioning

confidence: 99%

Management of anastomotic leaks after esophagectomy and gastric pull-up

Famiglietti¹,

Lazar²,

Henderson³

et al. 2020

J Thorac Dis

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Anastomotic leak is one of the most feared complications of esophagectomy, leading to prolonged hospital stay, increased postoperative mortality, and additional cost both to the patient and the hospital. Historically, anastomotic leaks have been treated with several techniques including conservative measures, percutaneous or operative drainage, primary surgical repair with buttressing, T-tube drainage, or excision of the esophageal replacement conduit with end esophagostomy. With advances in treatment modalities, including endoscopic stenting, clips and suturing, endoluminal vacuum-assisted closure (EVAC), such leaks increasingly are being managed without operative re-intervention and with salvage of the esophageal replacement conduit. For the purposes of this review, we identified studies analyzing the management of postoperative leak after esophagectomy. We then compared the efficacy of the various newer modalities for closure of anastomotic leaks and gastric conduit defects. We found both esophageal stent and EVAC sponges are effective treatments for closure of anastomotic leak. The chosen treatment modality for salvage of the esophageal replacement conduit is entirely dependent on the patient's clinical status and the surgeon's preference and experience. Emerging endoscopic and endoluminal therapies have increased the armamentarium of tools the esophageal surgeon has to facilitate successful resolution of anastomotic leaks following esophagectomy with reconstruction. While some literature suggests that EVACs have a slightly superior result in conduit success, we question this endorsement as EVACs mostly are utilized for contained leaks, many of which may have healed with conservative measures. This poses a challenge as there is clearly a bias given patient selection.

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Thoracoscopy in prone position with two-lung ventilation compared to conventional thoracotomy during Ivor Lewis procedure: a multicenter case–control study

Abstract: HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers.

Cited by 25 publications

References 33 publications

Short- and Long-Term Outcomes of Totally Versus Hybrid Minimally Invasive Ivor Lewis Oesophagectomy for Oesophageal Cancer: A Propensity Score-Matched Analysis

Short- and Long-Term Outcomes of Totally Versus Hybrid Minimally Invasive Ivor Lewis Oesophagectomy for Oesophageal Cancer: A Propensity Score-Matched Analysis

New Trends in Esophageal Cancer Management

Management of anastomotic leaks after esophagectomy and gastric pull-up

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