scholarly journals The Impact of Infectious Complications after Esophagectomy for Esophageal Cancer on Cancer Prognosis and Treatment Strategy

2021 ◽  
Vol 10 (19) ◽  
pp. 4614
Author(s):  
Eisuke Booka ◽  
Hirotoshi Kikuchi ◽  
Yoshihiro Hiramatsu ◽  
Hiroya Takeuchi
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive Esophagectomy ◽  
Treatment Strategies ◽  
Invasive Procedure ◽  
Infectious Complications ◽  
Pulmonary Complications ◽  
Cancer Prognosis ◽  
Term Survival ◽  
Invasive Esophagectomy ◽  
The Impact

Despite advances in the perioperative management of esophagectomy, it is still a highly invasive procedure for esophageal cancer and is associated with severe postoperative complications. The two major postoperative infectious complications after esophagectomy are pulmonary complications and anastomotic leakage. We previously reported that postoperative infectious complications after esophagectomy adversely affect long-term survival significantly in a single institution and meta-analysis. Additionally, we reviewed the mechanisms of proinflammatory cytokines, such as C-X-C motif ligand 8 (CXCL8) and its cognate receptor, C-X-C chemokine receptor 2 (CXCR2), in contributing to tumorigenesis and tumor progression. Moreover, we previously reported that introducing minimally invasive esophagectomy, including robot assistance, laparoscopic gastric mobilization, and multidisciplinary team management, significantly reduced postoperative infectious complications after esophagectomy. Further, this review also suggests future treatment strategies for esophageal cancer, considering the adverse effect of postoperative infectious complications after esophagectomy.

351 SINGLE-PORT MINIMALLY INVASIVE ESOPHAGECTOMY TO TREAT ESOPHAGEAL CANCER: EXPERIENCE OF 144 CASES

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Jang-Ming Lee ◽  
Chen Ke-Cheng ◽  
Lin Mong-Wei ◽  
Yang Pei-Wen ◽  
Huang Pei-Ming
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Single Incision ◽  
Single Port ◽  
Minimally Invasive Esophagectomy ◽  
Pulmonary Complications ◽  
Term Survival ◽  
Invasive Esophagectomy ◽  
Laparoscopic Procedures ◽  
The Mean

Abstract   Single-incision thoracoscopic and laparoscopic procedures has have been applied in treating various diseases. However, it is limited in literature for such procedures used in treating esophageal cancer. Methods Minimally invasive esophagectomy (MIE) with a single-incision approach in the thoracoscopic and laparoscopic procedures was attempted in 144 patients with esophageal cancer. Results There was 96 patients underwent a McKeown procedure and 48 an Ivor Lewis procedure repectively. The mean ventilator usage of the patients after surgery was 0.3 ± 0.6 days, the mean ICU stay was 7.42 ± 17.15 days, and the mean number of dissected lymph nodes was 43.5 ± 21.8. There 11 patients suffered from postoperative complications, including 3 pulmonary complications, 4 anastomotic leakage and 4 vocal cord palsy. There are no 30-day mortality, however, there were one patient died from ARDS 40 days after surgery. Conclusion Single-port MIE seems to be a feasible option for treating patients with esophageal cancer, which offers an acceptable perioperative surgical outcome. However, the long-term survival results of the patients requires to be follow-up in the future.

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.

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 Operative Outcomes of Minimally Invasive Esophagectomy versus Open Esophagectomy for Resectable Esophageal Cancer

2021 ◽  
Vol 10 (04) ◽  
pp. 230-235
Author(s):  
Ramachandra Chowdappa ◽  
Anvesh Dharanikota ◽  
Ravi Arjunan ◽  
Syed Althaf ◽  
Chennagiri S. Premalata ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Minimally Invasive Esophagectomy ◽  
Intraoperative Complications ◽  
Length Of Hospital Stay ◽  
Pulmonary Complications ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy ◽  
Operative Duration

Abstract Background There is a recent rise in the incidence of esophageal carcinoma in India. Surgical resection with or without neoadjuvant chemoradiation is the current treatment modality of choice. Postoperative complications, especially pulmonary complications, affect many patients who undergo open esophagectomy for esophageal cancer. Minimally invasive esophagectomy (MIE) could reduce the pulmonary complications and reduce the postoperative stay. Methodology We performed a retrospective analysis of prospectively collected data of 114 patients with esophageal cancer in the department of surgical oncology at a tertiary cancer center in South India between January 2019 and March 2020. We included patients with resectable cancer of middle or lower third of the esophagus, and gastroesophageal junction tumors (Siewert I). MIE was performed in 27 patients and 78 patients underwent open esophagectomy (OE). The primary outcome measured was postoperative complications of Clavien–Dindo grade II or higher within 30 days. Other outcomes measured include overall mortality within 30 days, intraoperative complications, operative duration and the length of hospital stay. Results A postoperative complication rate of 18.5% was noted in the MIE group, compared with 41% in the OE group (p = 0.034). Pulmonary complications were noted in 7.4% in the MIE group compared to 25.6% in the OE group (p = 0.044). Postoperative mortality rates, intraoperative complications, and other nonpulmonary postoperative complications were almost similar with MIE as with open esophagectomy. Although the median operative time was more in the MIE group (260 minutes vs. 180 minutes; p < 0.0001), the median length of hospital stay was shorter in patients undergoing MIE (9 days vs. 12 days; p = 0.0001). Conclusions We found that MIE resulted in lower incidence of postoperative complications, especially pulmonary complications. Although, MIE was associated with prolonged operative duration, it resulted in shorter hospital stay.

Minimally Invasive Esophagectomy

2019 ◽  
pp. 308-318
Author(s):  
Brandon Merling ◽  
Frank Dupont
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Anesthetic Management ◽  
Pulmonary Complications ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Perioperative Morbidity ◽  
Invasive Esophagectomy ◽  
Common Causes

Esophageal cancer is the eighth most common malignancy worldwide, producing a high morbidity and mortality rate around the globe. Minimally invasive esophagectomy (MIE) is most commonly performed on patients with this devastating disease. Esophagectomy is a high-risk procedure, and perioperative mortality remains around 5%–8%. Because esophageal cancer is associated with chronic alcohol and tobacco use, patients have serious comorbid conditions that affect anesthetic management and perioperative care. Among them, pulmonary complications and anastomotic failure remain the most common causes of perioperative morbidity and mortality. The anesthesiologist managing a patient during MIE must be able to reduce the effect of the patient’s multiple comorbidities intraoperatively while mitigating the factors that lead to adverse postoperative outcomes.

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