MINIMALLY INVASIVE ESOPHAGECTOMY FOR ESOPHAGEAL CANCER: THE FIRST EXPERIENCE FROM CAN THO UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL
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Abstract
Background: Two common procedures for esophageal resection are Ivor Lewis esophagectomy and transhiatal esophagectomy. Both procedures have high morbidity rates of 20– 46%. Recently, minimally invasive esophagectomy (MIE) has proved to be safe with low morbidity, low mortality (1.4-8%), short hospital stay and similar oncological outcomes. We report initial experience of MIE for esophageal cancer. Objectives: 1.) To analyse the indications and operative techniques of MIE; 2) To determine the morbidity and mortality associated with MIE. Materials and methods: This was a retrospective study of patients undergoing MIE for esophageal cancer in our CTUMP hospital from January 2015 to September 2021. Results: Twenty-five patients with esophageal cancer were indicated for MIE, in which 23 patients underwent MIE and the remainder underwent palliative procedures: esophageal stent placement and feeding gastrostomy. The mean age was 59 ± 9.2 (range, 41–81). Cancer of the middle third esophagus was 40% and the remainder was the lower third (60%). Postoperative morbidity included 9 (39.1%) patients with respiratory complications (6 pneumonia and 3 pleural effusions) successfully managed by medications and two anastomotic leaks (8.7%). Reoperation was required in these two patients with anastomotic leaks and one of them died afterwards (4.3%). The median operative time was 470.2 ± 98.9 minutes. The median ICU stay was 4,2 ±2,4 days. The median hospital stay was 18.2 ± 4.8 days. The long-term morbidity was anastomotic narrowing observed in 1 patient. Squamous cell carcinoma was the most common histopathological result (88%). Conclusions: Minimally invasive esophagectomy for esophageal cancer has an acceptable morbidity and mortality when performed in the learning phase.
Keywords
Thoracoscopic, laparoscopic, minimally invasive esophagectomy, esophageal cancer
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