Comparison Of Perioperative Outcomes Between Open And Thoracoscopic Iver-Lewis Esophagectomy

Objective Esophagectomy represents the standard in the treatment of esophageal cancer.To compare surgical outcomes of thoracoscopic esophagectomy with open esophagectomy in order to evaluate the safety and advantage of MIE.Methods From January 2016 to february 2018,110 cases underwent esophagectomy are retrospectively studied in the First Affiliated Hospital of Soochow University.Among 110 esophageal cancer patients,32 patients underwent minimally invasive esophagectomy(MIE)and 78 patients underwent open surgery(OE).The perioperative data,perioprative factors,postoperative complications,and short-term follow-up data were compared.Perioperative data includes histopathology,age,gender.Perioprative factors includes operation time,number of harvested lymph nodes,blood volume and hospital days after surgery.Postoperative complications includes anastomic leak,arrhythmia,pulmonary morbidity rate,recurrent laryngeal nerve injury,etc.Results The two groups were similar in terms of perioperative data(P=NS).The perioperative factors were also similar except hospital days after surgery(10.62±1.052 d VS 12.82±2.969 d,P<0.05).The overall morbidity of MIE and OE was 31.25%(10/32)and 48.71%(38/78),respectively,with no statistical difference.Therefore,the MIE group had a lower incidence of functional coplication(12.5%)than the OE group(30.77%,P<0.05).Conclusion Minimally invasive esophagectomy is almost equally safe and feasible to open operation.MIE may help decrease the risk of functional complication despite technical problems after esophagectomy.Therefore,a multicenter,prospective,randomized,controlled trial comparing MIE with OE are necessary in order to valuate long-term outcomes of this new procedure.