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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author Heinz Wykypiel
Philipp Gehwolf
Katrin Kienzl-Wagner
Valeria Wagner
Andreas Puecher
Thomas Schmid
Fergül Cakar-Beck
Aline Schäfer
author_facet Heinz Wykypiel
Philipp Gehwolf
Katrin Kienzl-Wagner
Valeria Wagner
Andreas Puecher
Thomas Schmid
Fergül Cakar-Beck
Aline Schäfer
author_sort Heinz Wykypiel
collection DOAJ
description 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.
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spelling doaj-art-24f4fec3b20544e286772ea1ec7efb1b2025-08-20T02:18:16ZengBMCBMC Surgery1471-24822024-10-0124111010.1186/s12893-024-02641-7Clinical implementation of minimally invasive esophagectomyHeinz Wykypiel0Philipp Gehwolf1Katrin Kienzl-Wagner2Valeria Wagner3Andreas Puecher4Thomas Schmid5Fergül Cakar-Beck6Aline Schäfer7Department of Visceral, Transplant and Thoracic Surgery, Medical University of InnsbruckDepartment of Visceral, Transplant and Thoracic Surgery, Medical University of InnsbruckDepartment of Visceral, Transplant and Thoracic Surgery, Medical University of InnsbruckDepartment of Visceral, Transplant and Thoracic Surgery, Medical University of InnsbruckDepartment of Visceral, Transplant and Thoracic Surgery, Medical University of InnsbruckDepartment of Visceral, Transplant and Thoracic Surgery, Medical University of InnsbruckDepartment of Visceral, Transplant and Thoracic Surgery, Medical University of InnsbruckDepartment of Visceral, Transplant and Thoracic Surgery, Medical University of InnsbruckSummary 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.https://doi.org/10.1186/s12893-024-02641-7EsophagusEsophageal tumorEsophagectomySurgical oncologyPerioperative medicinePathology, surgical
spellingShingle Heinz Wykypiel
Philipp Gehwolf
Katrin Kienzl-Wagner
Valeria Wagner
Andreas Puecher
Thomas Schmid
Fergül Cakar-Beck
Aline Schäfer
Clinical implementation of minimally invasive esophagectomy
BMC Surgery
Esophagus
Esophageal tumor
Esophagectomy
Surgical oncology
Perioperative medicine
Pathology, surgical
title Clinical implementation of minimally invasive esophagectomy
title_full Clinical implementation of minimally invasive esophagectomy
title_fullStr Clinical implementation of minimally invasive esophagectomy
title_full_unstemmed Clinical implementation of minimally invasive esophagectomy
title_short Clinical implementation of minimally invasive esophagectomy
title_sort clinical implementation of minimally invasive esophagectomy
topic Esophagus
Esophageal tumor
Esophagectomy
Surgical oncology
Perioperative medicine
Pathology, surgical
url https://doi.org/10.1186/s12893-024-02641-7
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AT andreaspuecher clinicalimplementationofminimallyinvasiveesophagectomy
AT thomasschmid clinicalimplementationofminimallyinvasiveesophagectomy
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