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Minimally invasive esophagectomy for esophageal cancer: Comparative analysis of open and hand‐assisted laparoscopic abdominal lymphadenectomy with gastric conduit reconstruction
Author(s) -
Yamasaki Makoto,
Miyata Hiroshi,
Fujiwara Yoshiyuki,
Takiguchi Shuji,
Nakajima Kiyokazu,
Kurokawa Yukinori,
Mori Masaki,
Doki Yuichiro
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21991
Subject(s) - medicine , laparotomy , esophageal cancer , esophagectomy , surgery , lymphadenectomy , laparoscopy , open surgery , cancer
Background and Objectives Esophagectomy for esophageal cancer is an invasive procedure. Minimally invasive approaches such as hand‐assisted laparoscopic surgery (HALS) might reduce surgical stress and improve postoperative course. Methods We retrospectively analyzed 216 consecutive patients who underwent esophagectomy for esophageal cancer through either HALS (109 patients) or open laparotomy (107 patients), through an abdominal approach. The peri‐ and postoperative outcomes were compared between the two groups. Results No significant difference was observed in physical and tumor status between the two groups. The mean operating time (HALS: 452 ± 65, Open: 456 ± 69 min) and mean number of resected lymph nodes (HALS: 19.3 ± 7.1, Open: 20.8 ± 8.3) were similar, while total blood loss was lower in HALS (HALS: 695 ± 369, Open: 1,101 ± 540 ml; P = 0.0001). The postoperative course showed marginally lower incidences of pulmonary (HALS: 6.4%, Open: 14.0%; P = 0.062) and overall complications (HALS: 23.9%, Open: 35.5%; P = 0.11), lower C‐reactive protein level at postoperative days 1, 3, and 7, and shorter duration of systemic inflammatory response syndrome (HALS: 2.3 days, Open: 3.5 days; P = 0.0002) in HALS than in OPEN. The disease‐free survival rates at 2 years were 65% in HALS and 53% in Open. Conclusions The findings suggest that HALS is feasible and useful for patients with esophageal cancer. J. Surg. Oncol. 2011; 104:623–628. © 2011 Wiley Periodicals, Inc.