Minimally Invasive Versus Open Esophagectomy for Patients With Esophageal Cancer

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dc.contributor.authorZingg, U.
dc.contributor.authorMcQuinn, A.
dc.contributor.authorDi Valentino, D.
dc.contributor.authorEsterman, A.
dc.contributor.authorBessell, J.
dc.contributor.authorThompson, S.
dc.contributor.authorJamieson, G.
dc.contributor.authorWatson, D.
dc.date.issued2009
dc.descriptionCopyright © 2009 The Society of Thoracic Surgeons Published by Elsevier Inc.
dc.description.abstract<h4>Background</h4>Minimally invasive esophagectomy (MIE) compared with open esophagectomy (OE) has been shown to have clinical advantages, but selection bias is present.<h4>Methods</h4>All patients undergoing MIE or OE for cancer between 1999 and 2007 were eligible for analysis. To minimize selection bias, only patients who also met the selection criteria for the thoracoscopic approach were included in the open esophagectomy group.<h4>Results</h4>Fifty-six patients underwent MIE and 98 OE. No significant differences in demographics or pathologic data between groups occurred, with the exception of thoracic epidural analgesia (OE 98%, MIE 71.1%, p < 0.001), and neoadjuvant treatment (OE 50.5%, MIE 71.4%, p = 0.016). Morbidity and in-hospital death were not significantly different. Duration of surgery was longer in MIE (250 vs 209 minutes, p < 0.001) and blood loss less (320 mL vs 857 mL, p < 0.001). Intensive care unit stay was shorter in MIE (3.0 vs 6.8 days, p = 0.022). The relative risk (RR) for in-hospital death was 0.57 (p = 0.475) if the patients underwent MIE. After adjusting for thoracic epidural analgesia, the RR was 0.29 (p = 0.213) for the MIE group. The RR for surgical morbidity was 1.47 (p = 0.154) for patients undergoing MIE. Neoadjuvant treatment increased the RR for surgical morbidity to 1.78 (p = 0.028). No difference between the two groups concerning survival occurred.<h4>Conclusions</h4>The MIE is comparable with the OE. In MIE, neoadjuvant treatment increased the risk of surgical morbidity. Thoracic epidural analgesia in MIE reduced the risk of in-hospital death and should be considered for all patients undergoing esophagectomy.
dc.description.statementofresponsibilityUrs Zingg, Alexander McQuinn, Dennis DiValentino, Adrian J. Esterman, Justin R. Bessell, Sarah K. Thompson, Glyn G. Jamieson, and David I. Watson
dc.identifier.citationAnnals of Thoracic Surgery, 2009; 87(3):911-919
dc.identifier.doi10.1016/j.athoracsur.2008.11.060
dc.identifier.issn0003-4975
dc.identifier.issn1552-6259
dc.identifier.orcidEsterman, A. [0000-0001-7324-9171]
dc.identifier.urihttp://hdl.handle.net/2440/50870
dc.language.isoen
dc.publisherElsevier Science Inc
dc.source.urihttps://doi.org/10.1016/j.athoracsur.2008.11.060
dc.subjectHumans
dc.subjectEsophageal Neoplasms
dc.subjectTreatment Outcome
dc.subjectEsophagectomy
dc.subjectSurvival Rate
dc.subjectAged
dc.subjectFemale
dc.subjectMale
dc.subjectMinimally Invasive Surgical Procedures
dc.titleMinimally Invasive Versus Open Esophagectomy for Patients With Esophageal Cancer
dc.typeJournal article
pubs.publication-statusPublished

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