A comparative study of the therapeutic effect in two protocols: video-assisted thoracic surgery combined with laparoscopy versus right open transthoracic esophagectomy for esophageal cancer management

Guo, Ming; Xie, Binbin; Sun, Xiaoyan; Hu, Meng; Yang, Qiaoyun; Lei, Yunhong

doi:10.1007/s10330-012-0966-0

Cited by 23 publications

(40 citation statements)

References 7 publications

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“…All 124 cases were treated surgically via esophagectomy using an MIE procedure (thoracoscopy combined with laparoscopy) rather than hybrid MIE (either a thoracoscopic or laparoscopic approach). The mean surgical duration was 376 minutes, and the average blood loss was 156 mL, similar to results reported in previous studies . A previous meta‐analysis reported that the amount of bleeding that occurred during MIE was less than during opening esophagectomy (OE), but the operation time was slightly longer than that of OE .…”

Section: Discussionsupporting

confidence: 83%

“…The mean surgical duration was 376 minutes, and the average blood loss was 156 mL, similar to results reported in previous studies. 5,6 A previous meta-analysis reported that the amount of bleeding that occurred during MIE was less than during opening esophagectomy (OE), but the operation time was slightly longer than that of OE. 7 However, two of our cases suffered from hemorrhage during mobilization of the stomach; the bleeding occurred at the short gastric artery upper pole of the spleen, which is also the area where bleeding often occurs during OE.…”

Section: Data Relevant To Learning Curvementioning

confidence: 99%

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Minimally invasive esophagectomy in the lateral‐prone position: Experience of 124 cases in a single center

Yan

Liu

et al. 2017

Thoracic Cancer

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BackgroundMinimally invasive esophagectomy was first introduced as a new technique for esophageal cancer treatment 20 years ago. Performing this procedure in the lateral‐prone position is the most appropriate method. Since May 2013, our center has performed 124 esophageal cancer operations using this procedure. Herein, we share our experience.MethodsWe retrospectively reviewed 124 consecutive patients who had received minimally invasive esophagectomy in the lateral‐prone position from May 2013 to June 2017. The procedure, operative variables, postoperative complications, and oncology outcomes were assessed.ResultsThe surgery was successful in all 124 patients; three cases converted to an abdominal opening procedure during surgery. The mean total lymph node harvest was 19.2: 12.9 in the thoracic cavity and 6.0 in the abdominal cavity. The average total operation duration was 376 minutes and blood loss was 156 mL. No mortality occurred within 30 postoperative days. Forty‐three cases of postoperative morbidity occurred in 38 patients (30.6%), including 11 anastomotic leakages (8.9%), 1 chyle leak (0.8%), 12 lateral recurrent nerve palsies (9.7%), 11 pulmonary complications (8.9%), and 8 other complications (6.5%). A learning curve indicated that blood loss, operation duration, and the number of lymph nodes harvested would improve with time.ConclusionsSurgical and oncological outcomes following minimally invasive esophagectomy for esophageal cancer were acceptable. There are some advantages to this technique compared to previous reports of opening procedures.

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Section: Discussionsupporting

confidence: 83%

Section: Data Relevant To Learning Curvementioning

confidence: 99%

Minimally invasive esophagectomy in the lateral‐prone position: Experience of 124 cases in a single center

Yan

Liu

et al. 2017

Thoracic Cancer

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“…Esophageal surgery has been historically considered a challenge for the surgeon, essentially due to significant rates of morbidity and mortality and dismal oncological outcomes . The introduction of multimodal therapy and especially neoadjuvant chemoradiotherapy (CRT) has considerably improved the outcomes of patients with esophageal malignancy during recent decades . Substantive changes have also been introduced in surgical practice, with the aim of offering a less invasive procedure while ensuring oncological radicality and expected survival .…”

Section: Introductionmentioning

confidence: 99%

“…Substantive changes have also been introduced in surgical practice, with the aim of offering a less invasive procedure while ensuring oncological radicality and expected survival . Indeed, although esophagectomy was originally considered a relative contraindication to the application of minimally invasive surgery (MIS), in recent years laparoscopy/thoracoscopy has progressively gained popularity, substantially due to favorable perioperative outcomes . Moreover, several concerns regarding oncological adequacy have now been allayed …”

Section: Introductionmentioning

confidence: 99%

Early experience with totally robotic esophagectomy for malignancy. Surgical and oncological outcomes

Guerra

Vegni

Gia

et al. 2018

Robotics Computer Surgery

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“…Minimally invasive surgery is assumed to reduce surgical injury on the one hand and improve patients’ prognosis on the other. Guo et al4 had conducted a prospective randomized study and their results indicated that MIE had some short-term benefits such as less hemorrhage, better recovery, and fewer complications but no difference in long-term survival rate in comparison with open surgery. A recently randomized trial conducted by Maas et al5 suggests that MIE is associated with a better one-year quality of life compared with OE.…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive esophagectomy versus open esophagectomy for esophageal cancer: a meta-analysis

Ren

et al. 2016

OTT

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Background and objectivesThe safety and effectiveness of minimally invasive esophagectomy (MIE) in comparison with the open esophagectomy (OE) remain uncertain in esophageal cancer treatment. The purpose of this meta-analysis is to compare the outcomes of the two surgical modalities.MethodsSearches were conducted in MEDLINE, EMBASE, and ClinicalTrials.gov with the following index words: “esophageal cancer”, “VATS”, “MIE”, “thoracoscopic esophagectomy”, and “open esophagectomy” for relative studies that compared the effects between MIE and OE. Random-effect models were used, and heterogeneity was assessed.ResultsA total of 20 studies were included in the analysis, consisting of four randomized controlled trials and 16 prospective studies. MIE has reduced operative blood loss (P=0.0009) but increased operation time (P=0.009) in comparison with OE. Patients get less respiratory complications (risk ratio =0.74, 95% CI =0.58–0.94, P=0.01) and better overall survival (hazard ratio =0.54, 95% CI =0.42–0.70, P<0.00001) in the MIE group than the OE group. No statistical difference was observed between the two groups in terms of lymph node harvest, R0 resection, and other major complications.ConclusionMIE is a better choice for esophageal cancer because patients undergoing MIE may benefit from reduced blood loss, less respiratory complications, and also improved overall survival condition compared with OE. However, more randomized controlled trials are still needed to verify these differences.

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A comparative study of the therapeutic effect in two protocols: video-assisted thoracic surgery combined with laparoscopy versus right open transthoracic esophagectomy for esophageal cancer management

Cited by 23 publications

References 7 publications

Minimally invasive esophagectomy in the lateral‐prone position: Experience of 124 cases in a single center

Minimally invasive esophagectomy in the lateral‐prone position: Experience of 124 cases in a single center

Early experience with totally robotic esophagectomy for malignancy. Surgical and oncological outcomes

Minimally invasive esophagectomy versus open esophagectomy for esophageal cancer: a meta-analysis

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