Short-term outcomes following total minimally invasive oesophagectomy

Br J Surg. 2008 May;95(5):602-10. doi: 10.1002/bjs.6054.


Background: Minimally invasive oesophagectomy (MIO; thoracoscopy, laparoscopy, cervical anastomosis) is a complex procedure and few substantial series have been published. This study documented the morbidity, mortality and challenges of adopting MIO in a specialist unit in the UK.

Methods: A prospective group of 77 patients was listed consecutively with the intention of performing MIO. Three other patients underwent open oesophagectomy during the study period.

Results: MIO was attempted in 77 patients, completed successfully in 70, abandoned in six patients (8 per cent) with unsuspected metastatic disease, and converted to a thoracoscopic anastomosis in one patient. There was one in-hospital death (1 per cent). Complications occurred in 33 patients (47 per cent), including nine gastric conduit-related complications (13 per cent). Median lymph node harvest was 21 (range 7-48) nodes. Mean overall and disease-free survival times were 35 and 33 months respectively. Median disease-free survival for patients with stage III disease was 26 months.

Conclusion: MIO can be performed with acceptable mortality and morbidity rates in an unselected series of patients. There was more morbidity related to gastric tube ischaemia than was expected.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical / methods
  • Blood Loss, Surgical
  • Disease-Free Survival
  • Emergency Treatment
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / methods*
  • Esophagectomy / mortality
  • Female
  • Humans
  • Intraoperative Complications / etiology
  • Length of Stay
  • Ligation / methods
  • Ligation / mortality
  • Lymph Node Excision / methods
  • Lymph Node Excision / mortality
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Postoperative Care / methods
  • Prospective Studies
  • Thoracoscopy / methods*
  • Thoracoscopy / mortality