Minimally invasive esophagectomy reduces morbidity

Share this article:

Patients with resectable esophageal cancer may reap more short-term benefits from minimally invasive esophagectomy, including fewer pulmonary infections, significantly shorter hospital stays, and better short-term quality of life, than do patients who have undergone traditional open surgery.

These findings come from the first randomized trial to compare the two methods, recently reported in The Lancet and involving 115 participants, aged 18 to 75 years, with resectable cancer of the esophagus or the gastroesophageal junction. Prof. Miguel A. Cuesta of the Department of Surgery at VU University Medical Centre, Amsterdam, Netherlands, and colleagues randomized patients from five study centers in the Netherlands, Spain, and Italy to open transthoracic esophagectomy or to minimally invasive transthoracic esophagectomy. The latter avoids thoracotomy and laparotomy. As the authors explain, surgical resection is regarded as the only curative option for resectable esophageal cancer, but pulmonary complications occurring in more than half of patients after open esophagectomy are of great concern.

In the first 2 weeks postoperatively, 16 of the 56 patients (29%) in the open esophagectomy group developed pulmonary infections, compared with five of the 59 patients (9%) undergoing minimally invasive surgery. In-hospital pulmonary infections developed in 19 (34%) of the open surgery patients, compared with seven (12%) of the minimally invasive patients.

The minimally invasive group also had significantly less blood loss and shorter hospital stays as well as significantly less pain and vocal-cord paralysis.

The investigators noted no compromise in the quality of the resected specimen and no significant difference in the number of lymph nodes retrieved, the number of reoperations, or the rate of postoperative mortality between the two groups. One patient in the open surgery group died in the hospital as a result of anastomotic leakage, and two in the minimally invasive group died in the hospital as a result of aspiration and mediastinitis after anastomotic leakage. 

Share this article:
You must be a registered member of ONA to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings


Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs

More in Web Exclusives

Improved tyrosine kinase inhibitor (TKI) selectively activates in tumor tissue, minimizing side ...

A new strategy developed by an interdisciplinary team of researchers aims to reduce the side effects connected to use of tyrosine kinase inhibitors (TKIs).

Prior cancer exclusion criteria may stymie potential of lung cancer clinical trials

A history of prior cancer can exclude many individuals from participation in clinical trails related to lung cancer, even when the prior cancer is unlikely to interfere with treatment outcomes.

Better adherence to guidelines for safe handling of antineoplastic drugs is needed

Recommended safe handling practices for workers who administer antineoplastic drugs in health care settings are not always followed, according to a new study.