Clinical implementation of minimally invasive esophagectomy

Summary 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 tota...

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Main Authors: Heinz Wykypiel, Philipp Gehwolf, Katrin Kienzl-Wagner, Valeria Wagner, Andreas Puecher, Thomas Schmid, Fergül Cakar-Beck, Aline Schäfer
Format: Article
Language:English
Published: BMC 2024-10-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-024-02641-7
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Summary:Summary 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.
ISSN:1471-2482