Minimally invasive esophagectomy attenuates the postoperative inflammatory response and improves survival compared with open esophagectomy in patients with esophageal cancer: a propensity score matched analysis

Yamashita, Kotaro; Watanabe, Masayuki; Mine, Shinji; Toihata, Tasuku; Fukudome, Ian; Okamura, Akihiko; Yuda, Masami; Hayami, Masaru; Ishizuka, Naoki; Imamura, Yu

doi:10.1007/s00464-018-6187-z

Cited by 46 publications

(31 citation statements)

References 26 publications

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“…Except for the differences in approach to lymphanectomy of the left and right approaches, the surgical incision itself may affect the survival. With the same extent of lymphanectomy, another retrospective study has demonstrated that the MIE could achieve lower operative morbidity and long time survival benefits (12). The survival benefits may due to the different incisions.…”

Section: Figure 1 | Kaplan-meier Curves For Comparison Of Overall Surmentioning

confidence: 99%

Right Compared With Left Thoracic Approach Esophagectomy for Patients With Middle Esophageal Squamous Cell Carcinoma

Zheng

Liu

et al. 2020

Front. Oncol.

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Background: In China, open surgical approaches for esophageal cancer (EC) can be divided into two techniques, the right-and left-transthoracic esophagectomy. Although there is an increasing number of instances that use the right side, the optimal surgical technique remains unclear. Based in a large cancer center with rich experience of both transthoracic side approaches, this study compared the long-term survival of patients treated by these two surgical techniques. Methods: The patients included in this study underwent a right transthoracic esophagectomy (Right, McKeown) or left transthoracic esophagectomy (Left, Sweet, or chest neck dual-incision) for esophageal squamous cell carcinoma (ESCC) between January 2015 and October 2018. The overall survival(OS) rate and perioperative data between the two groups were then retrospectively analyzed. Results: We included 437 patients who underwent Right (n = 202) and Left (n = 235) approaches for ESCC. There was a significantly longer median operative time (250 vs. 190 min, P < 0.001) and longer median postoperative hospital stay (17 vs. 14 days, P < 0.001) in the Right side group. The OS at 5-years was 49.9% in the Right group and 52.45% in the Left group; hazard ratio (HR) (95% CI): 1.002 (0.752-1.337), p = 0.987. Conclusions: For middle thoracic ESCC without suspected lymph node metastasis in the upper mediastinum, the esophagectomy through the Left thoracic approach could achieve the same OS as the Right side, with better short-term outcomes.

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Section: Figure 1 | Kaplan-meier Curves For Comparison Of Overall Surmentioning

confidence: 99%

Right Compared With Left Thoracic Approach Esophagectomy for Patients With Middle Esophageal Squamous Cell Carcinoma

Zheng

Liu

et al. 2020

Front. Oncol.

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“…Based on the short‐term and long‐term results of the TIME trial, they concluded that MIE is useful for treating esophageal cancer . Yamashita et al compared short‐term and long‐term outcomes between 121 OE and 121 MIE using propensity score matching. All MIE consisted of TEP.…”

Section: Minimally Invasive Esophagectomy Versus Open Esophagectomymentioning

confidence: 99%

“…DFS and OS rates were significantly better in the MIE group than in the OE group (3‐year DFS rate, 81.7% vs 69.3%; log‐rank P = 0.021; 3‐year OS rate, 89.9% vs 79.2%; log‐rank P = 0.007) (Table ). The authors concluded that MIE is an independent prognostic factor for patients with esophageal cancer . Takeuchi et al compared short‐term outcomes between MIE, including both TELD and TEP, and OE using a nationwide database in Japan.…”

Section: Minimally Invasive Esophagectomy Versus Open Esophagectomymentioning

confidence: 99%

Current status of minimally invasive esophagectomy for esophageal cancer: Is it truly less invasive?

Oshikiri

Takiguchi

Miura

et al. 2018

Annals of Gastroent Surgery

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Esophagectomy with extended lymphadenectomy remains the mainstay of treatment for localized esophageal cancer. However, it is one of the most invasive procedures with high morbidity. To reduce invasiveness, minimally invasive esophagectomy (MIE), which includes thoracoscopic, laparoscopic, mediastinoscopic, and robotic surgery, is becoming popular worldwide. Thoracoscopic esophagectomy in the prone position is ergonomic for the surgeon and has better perioperative arterial oxygen pressure/fraction of inspired oxygen (P/F) ratio. Thoracoscopic esophagectomy in the left decubitus position is easy to introduce because it is similar to standard right posterolateral open esophagectomy (OE) in position. It has a relatively short operative time. Laparoscopic approach could potentially have a substantial effect on pneumonia prevention under the condition of thoracotomy. Mediastinoscopic surgery has the potential to reduce pulmonary complications because it can avoid a transthoracic procedure. In robotic surgery, in the future, less recurrent laryngeal nerve palsy will be expected as a result of polyarticular fine maneuvering without human tremors. In studies comparing MIE with OE, mediastinoscopic surgery and robotic surgery are usually not included; these studies show that MIE has a longer operative time and less blood loss than OE. MIE is particularly beneficial in reducing postoperative respiratory complications such as atelectasis, despite no dramatic decrease in pneumonia. Reoperation might occur more frequently with MIE. There is no significant difference in mortality rate between MIE and OE. It is important to recognize that the advantages of MIE, particularly “less invasiveness”, can be of benefit at facilities with experienced medical personnel.

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“…[ 24 ] Due to some high quality studies were published recently, we can take this advantage to conduct a systematic review and meta-analysis with higher level of evidences. [ 25 – 29 ] Moreover, in order to minimize the heterogeneity and bias, we will select randomized controlled trials (RCTs) and propensity score matched comparative studies which matched across a range of baseline factors to generate 2 similar groups for comparison. If data are sufficient, we will also conduct subgroup analyses in different surgical procedures of MIE.…”

Section: Introductionmentioning

confidence: 99%

Matched-pair comparisons of minimally invasive esophagectomy versus open esophagectomy for resectable esophageal cancer

Wang

Liu

et al. 2018

Medicine

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Background:Open esophagectomy (OE) with radical lymphadenectomy is known as one of the most invasive digestive surgeries with the high rate of complications. Minimally invasive esophagectomy (MIE) has developed very rapidly and has formed several available technical approaches. This systematic review and meta-analysis is aiming at how beneficial, and to what extent MIE resection really will be.Methods:A systematic literature search will be performed through May 31, 2018 using MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and Google Scholar for relevant articles published in any language. Randomized controlled trials, prospective cohort studies, and propensity score matched comparative studies will be included. If data are sufficient, subgroup analyses will be conducted in different surgical procedures of MIE.Results:The results of this systematic review and meta-analysis will be published in a peer-reviewed journal.Conclusion:This will be the first systematic review and meta-analysis using data of randomized controlled, prospective, and propensity score matched comparative studies to compare the outcomes between MIE and OE updating to May 31, 2018.

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Minimally invasive esophagectomy attenuates the postoperative inflammatory response and improves survival compared with open esophagectomy in patients with esophageal cancer: a propensity score matched analysis

Abstract: MIE significantly attenuated postoperative serum CRP levels compared with OE. MIE could contribute to improved survival.

Cited by 46 publications

References 26 publications

Right Compared With Left Thoracic Approach Esophagectomy for Patients With Middle Esophageal Squamous Cell Carcinoma

Right Compared With Left Thoracic Approach Esophagectomy for Patients With Middle Esophageal Squamous Cell Carcinoma

Current status of minimally invasive esophagectomy for esophageal cancer: Is it truly less invasive?

Matched-pair comparisons of minimally invasive esophagectomy versus open esophagectomy for resectable esophageal cancer

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