Results of the introduction of a minimally invasive esophagectomy program in
a tertiary referral center
RLGM Blom1, JHG Klinkenbijl1, MW Hollmann2, ORC Busch1, MI van Berge Henegouwen1
1
Department of Surgery, Academic Medical Center, Amsterdam
2
Department of Anesthesiology, Academic Medical Center, Amsterdam
Conventional open esophagectomies are accompanied by a high rate of postoperative
complications. Although not yet proven by randomized clinical trials, minimally invasive
esophageal surgery appears to be a promising technique that could be associated with a
lower morbidity rate. The objective of this study was to compare the results of minimally
invasive esophagectomies to conventional open esophagectomies in a non-randomized
patient series.
Preoperative characteristics and the postoperative course of patients that underwent a
transthoracic esophagectomy for esophageal carcinoma were registered in a prospectively
monitored database. The results of patients that underwent a minimally invasive
esophagectomy and a conventional open resection were compared.
From October 2009 until November 2010 a total of 73 esophageal cancer patients underwent
a transthoracic resection of whom 34 by means of a minimally invasive resection.
Preoperative characteristics were comparable for both groups. There was a trend towards a
shorter hospital stay in the minimally invasive group (10.5 versus 13.5 days, p=0.19). The
overall complication rate was 63% in both groups; pulmonary complications were present in
32% of patients in the open TTOCR group versus 31% in the MIE group.
Conclusion: The morbidity after a minimally invasive resection or an open transthoracic
esophageal resection is comparable. Furthermore, there is a trend towards a shorter hospital
stay after minimally invasive surgery. Therefore, minimally invasive esophagectomies
appears to be a safe technique for patients with potentially curable esophageal carcinoma.