Clinical implementation of minimally invasive esophagectomy

BMC Surg. 2024 Oct 28;24(1):337. doi: 10.1186/s12893-024-02641-7.

Abstract

Background: Minimally invasive surgery is becoming the method of choice for the resection of esophageal cancer worldwide.

Methods: Retrospective analysis of prospectively collected clinical data in a tertiary care center with a detailed description of the course of the program.

Results: A total of 136 transthoracic esophageal resections were performed between 2010 and 2023. The study group included 116 operations, 69 of which were fully minimally invasive and 47 hybrid. 80.0% of the study group underwent surgery using a multimodality approach. The median operation time was 431 min (± 103). The R0 resection rate was 100%. Forty-two patients (36.2%) had no postoperative complications. The postoperative Clavien-Dindo > IIIb morbidity was 27%. The postoperative 90-d mortality rate was 1.7%. The average number of lymph nodes removed in the last quarter of cancer patients was 31. The anastomotic insufficiency rate for reoperation was 4% (Ivor-Lewis 4.2%, McKeown 5%).

Conclusions: With extensive expertise in high-end minimally invasive abdominal and thoracic surgery, implementation of a minimally invasive esophageal resection program with a clinical and oncologic outcome within generally accepted limits is feasible.

Keywords: Esophageal tumor; Esophagectomy; Esophagus; Pathology, surgical; Perioperative medicine; Surgical oncology.

MeSH terms

  • Aged
  • Esophageal Neoplasms* / surgery
  • Esophagectomy* / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures* / methods
  • Operative Time
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Treatment Outcome