Robotic Minimally Invasive Esophagectomy (RAMIE) vs. Open Esophagectomy (OE) for Resectable Esophageal Cancer

2020 ◽  
pp. 361-368
Author(s):  
John J. Brady ◽  
Tadeusz Witek ◽  
Inderpal S. Sarkaria
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy ◽  
Resectable Esophageal ◽  
Resectable Esophageal Cancer

Minimally invasive esophagectomy

2021 ◽  
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Respiratory Complications ◽  
Invasive Esophagectomy ◽  
Video Tutorial ◽  
Complex Procedure ◽  
Resectable Esophageal ◽  
Resectable Esophageal Cancer ◽  
Invasive Techniques

Minimally invasive esophagectomy is increasingly becoming the surgical treatment of choice for esophageal cancer. The goal of this technique is to reduce the rate of respiratory complications associated with thoracotomy while taking advantage of the benefits of reduced mortality associated with minimally invasive techniques. However, minimally invasive esophagectomy is still not considered the gold standard for resectable esophageal cancer worldwide because it is a highly technical and complex procedure. The goal of this video tutorial is to present an easy step-by-step approach to a minimally invasive esophagectomy and to address technical considerations and potential pitfalls.

scholarly journals Minimally Invasive Esophagectomy

2019 ◽  
Vol 37 (2) ◽  
pp. 93-100 ◽  
Author(s):  
Pieter Christiaan van der Sluis ◽  
Dimitrios Schizas ◽  
Theodore Liakakos ◽  
Richard van Hillegersberg
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Invasive Procedure ◽  
Current Status ◽  
Invasive Esophagectomy ◽  
Laparoscopic Esophagectomy ◽  
Resectable Esophageal ◽  
Resectable Esophageal Cancer ◽  
Invasive Techniques

Minimally invasive esophagectomy (MIE) was introduced in the 1990s with the aim to decrease the rate of respiratory complications associated with thoracotomy, along with the benefits of reduced morbidity and a quicker return to normal activities provided by minimally invasive techniques. However, MIE is not routinely applied as a standard approach for esophageal cancer worldwide, due to the high technical complexity of this minimally invasive procedure. Therefore, the open transthoracic esophagectomy is considered to be the gold standard for resectable esophageal cancer worldwide nowadays. In this article, the current status of conventional MIE and robot-assisted minimally invasive thoraco-laparoscopic esophagectomy will be reviewed.

696 LONG-TERM OUTCOMES OF MINIMALLY INVASIVE ESOPHAGECTOMY COMPARED TO OPEN ESOPHAGECTOMY: A RETROSPECTIVE ANALYSIS OF 2958 CASES IN SINGLE CANCER CENTER

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Xue-feng Leng ◽  
Kexun Li ◽  
Qifeng Wang ◽  
Wenwu He ◽  
Kun Liu ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Cancer Center ◽  
Term Survival ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy ◽  
Single Cancer

Abstract   Esophageal cancer is the fourth primary cause of cancer-related death in the male in China.The cornerstone of treatment for resectable esophageal cancer is surgery. With the development of minimally invasive esophagectomy (MIE), it is gradually adopted as an alternative to open esophagectomy (OE) in real-world practice. The purpose of this study is to explore whether MIE vs. OE will bring survival benefits to patients with the advancement of treatment techniques and concepts. Methods Data were obtained from the Sichuan Cancer Hospital & Institute Esophageal Cancer Case Management Database (SCH-ECCM Database). We retrospective analyzed esophageal cancer patients who underwent esophagectomy from Jan. 2010 to Nov. 2017. Patients were divided into two groups: MIE and OE groups. Clinical outcome and survival data were compared using TNM stages of AJCC 8th edition. Results After 65.3 months of median follow-up time, 2958 patients who received esophagectomy were included. 1106 of 2958 patients (37.4%) were underwent MIE, 1533 of 2958 patients (51.8%) were underwent OE. More than half of the patients (56.7%, 1673/2958) were above stage III. The median overall survival (OS) of 2958 patients was 51.6 months (95% CI 45.2–58.1). The MIE group's median OS was 74.6 months compared to 42.4 months in the OE group (95% CI 1.23–1.54, P < 0.001). The OS at 1, 3, and 5 years were 90%, 68%, 58% in the MIE group; 85%, 54%, 42% in the OE group,respectively (P<0.001). Conclusion The nearly 8-year follow-up data from this single cancer center suggests that with the advancement of minimally invasive surgical technology, MIE can bring significant benefits to patients' long-term survival compared with OE. Following the continuous progression of minimally invasive surgery and establishing a mature surgical team, MIE should be encouraged.

Costs and benefits of different methods of esophagectomy for esophageal cancer

2017 ◽  
Vol 25 (7-8) ◽  
pp. 513-517 ◽  
Author(s):  
Alongkorn Yanasoot ◽  
Kamtorn Yolsuriyanwong ◽  
Sakchai Ruangsin ◽  
Supparerk Laohawiriyakamol ◽  
Somkiat Sunpaweravong
Keyword(s):  
Esophageal Cancer ◽  
Postoperative Pain ◽  
Minimally Invasive ◽  
Operative Time ◽  
Minimally Invasive Esophagectomy ◽  
Laparoscopic Approach ◽  
Costs And Benefits ◽  
Invasive Approach ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy

Background A minimally invasive approach to esophagectomy is being used increasingly, but concerns remain regarding the feasibility, safety, cost, and outcomes. We performed an analysis of the costs and benefits of minimally invasive, hybrid, and open esophagectomy approaches for esophageal cancer surgery. Methods The data of 83 consecutive patients who underwent a McKeown’s esophagectomy at Prince of Songkla University Hospital between January 2008 and December 2014 were analyzed. Open esophagectomy was performed in 54 patients, minimally invasive esophagectomy in 13, and hybrid esophagectomy in 16. There were no differences in patient characteristics among the 3 groups Minimally invasive esophagectomy was undertaken via a thoracoscopic-laparoscopic approach, hybrid esophagectomy via a thoracoscopic-laparotomy approach, and open esophagectomy by a thoracotomy-laparotomy approach. Results Minimally invasive esophagectomy required a longer operative time than hybrid or open esophagectomy ( p = 0.02), but these patients reported less postoperative pain ( p = 0.01). There were no significant differences in blood loss, intensive care unit stay, hospital stay, or postoperative complications among the 3 groups. Minimally invasive esophagectomy incurred higher operative and surgical material costs than hybrid or open esophagectomy ( p = 0.01), but there were no significant differences in inpatient care and total hospital costs. Conclusion Minimally invasive esophagectomy resulted in the least postoperative pain but the greatest operative cost and longest operative time. Open esophagectomy was associated with the lowest operative cost and shortest operative time but the most postoperative pain. Hybrid esophagectomy had a shorter learning curve while sharing the advantages of minimally invasive esophagectomy.

Long-term survival in esophageal cancer after minimally invasive esophagectomy compared to open esophagectomy

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Eivind Gottlieb-Vedi ◽  
Joonas H. Kauppila ◽  
Fredrik Mattsson ◽  
Mats Lindblad ◽  
Magnus Nilsson ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Term Survival ◽  
Long Term Survival ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy

623 MINIMALLY INVASIVE VERSUS OPEN MCKEOWN FOR PATIENTS WITH ESOPHAGEAL CANCER: A RETROSPECTIVE STUDY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Yan Zheng ◽  
Wenqun Xing ◽  
Xianben Liu ◽  
Haibo Sun
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Group 14 ◽  
Term Survival ◽  
Long Term Survival ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy ◽  
Surgery Department

Abstract   McKeown Minimally invasive esophagectomy(McKeown-MIE) offers advantages in short-term outcomes compared with McKeown open esophagectomy(McKeown-OE). However, debate as to whether MIE is equivalent or better than OE regarding survival outcomes is ongoing. The aim of this study was to compare long-term survival between McKeown-MIE and McKeown-OE in a large cohort of esophageal cancer(EC) patients. Methods We used a prospective database of the Thoracic Surgery Department at our Cancer Hospital and included patients who underwent McKeown-MIE and McKeown-OE for EC during January 1, 2015, to January 6, 2018. The perioperative data and overall survival(OS) rate in the two groups were retrospectively compared. Results We included 502 patients who underwent McKeown-MIE (n = 306) or McKeown-OE (n = 196) for EC. The median age was 63 years. All baseline characteristics were well-balanced between two groups. There was a significantly shorter mean operative time (269.76 min vs. 321.14 min, P < 0.001) in OE group. The 30-day and in hospital mortality were 0 and no difference for 90-day mortality (P = 0.116). The postoperative stay was shorter in MIE group, 14 days and 18 days in the MIE and OE groups(P < 0.001). The OS at 32 months was 76.82% and 64.31% in the MIE and OE groups (P = 0.001); hazard ratio(HR) (95% CI): 2.333 (1.384–3.913). Conclusion These results showed the McKeown-MIE group was associated with a better long-term survival, compared with open-MIE for patients with resectable EC.

scholarly journals Micronutrient Deficiencies Following Minimally Invasive Esophagectomy for Cancer

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 778
Author(s):  
Henricus J.B. Janssen ◽  
Laura F.C. Fransen ◽  
Jeroen E.H. Ponten ◽  
Grard A.P. Nieuwenhuijzen ◽  
Misha D.P. Luyer
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Survival Rates ◽  
Micronutrient Deficiencies ◽  
Postoperative Evaluation ◽  
Invasive Esophagectomy ◽  
Resectable Esophageal ◽  
Resectable Esophageal Cancer ◽  
Esophagectomy For Cancer

Over the past decades, survival rates for patients with resectable esophageal cancer have improved significantly. Consequently, the sequelae of having a gastric conduit, such as development of micronutrient deficiencies, become increasingly apparent. This study investigated postoperative micronutrient trends in the follow-up of patients following a minimally invasive esophagectomy (MIE) for cancer. Patients were included if they had at least one postoperative evaluation of iron, ferritin, vitamins B1, B6, B12, D, folate or methylmalonic acid. Data were available in 83 of 95 patients. Of these, 78.3% (65/83) had at least one and 37.3% (31/83) had more than one micronutrient deficiency at a median of 6.1 months (interquartile range (IQR) 5.4–7.5) of follow-up. Similar to the results found in previous studies, most common deficiencies identified were: iron, vitamin B12 and vitamin D. In addition, folate deficiency and anemia were detected in a substantial amount of patients in this cohort. At 24.8 months (IQR 19.4–33.1) of follow-up, micronutrient deficiencies were still common, however, most deficiencies normalized following supplementation on indication. In conclusion, patients undergoing a MIE are at risk of developing micronutrient deficiencies as early as 6 up to 24 months after surgery and should therefore be routinely checked and supplemented when needed.

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