Background
The aim of this study is to evaluate the safety and feasibility of minimally invasive esophagealsurgery for esophageal cancer in a small volume center.
Patients
• Study Period: June 2017 to December 2020
; Inclusion criteria
ü ; Patients who underwent VATS esophagectomy as well as Laparoscopic gastric mobilization
ü ; Squamous cell carcinoma
ü ; Using gastric conduit
; Exclusion criteria
ü ; Patients who used colons for substitutes
ü ; Surgeries with open thoracotomy or laparotomy
ü ; Pathologic diagnosis other then sqcc.
Methods
; Retrospective review of medical records who underwent surgical treatment for their esophageal cancer
üAnalysis of patients characteristics including age, gender, body mass indices, smoking/alcohol behaviour and comorbidities
üAnalysis of perioperative findings including laboratory results, Intensive care unit stay duration, chest tube/Levin tube indwelling duration.
ü Postoperative complication rates (more than grade II according to the Modified Clavien-Dindo classification) were analyzed
üRisk factors assessment by comparison patients who with complication and who did not
Results
Patients
§A total of 45 patients were included
ü41 men, 4 women
§Mean follow-up periods
ü19.2±12.77 (95% Confidential interval; 15.4-23.0)
§Mean age at the time of treatment
ü65.1±7.92 (95% Confidential interval; 62.8-67.5)
§Diagnosed as esophageal squamous cell carcinoma
§Three patients underwent cervical lymph node dissection simultaneously
§Neoadjuvant CCRT
üChemotherapy alone; 4
üCombined chemo and radiation therapy ; 11
üRadiation alone; 0
§Patients classification
üPatients with complication ≥ Grade II ; 9 patients (20%)
üPatients without complication or with complication grade I; 36 patients (80%)
§Age and pulmonary arterial Pressure showed significant differences between those two groups.
§Other characteristics including comorbidities and smoking alcohol behavior, preoperative pulmonary function tests showed no significant differences
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Perioperative findings
§Hospital stay was significantly longer than in patients with complications (p=0.006)
§Preoperative WBC and Neutrophil counts were significantly lower than in patients with complication (p=0.013 and p=0.012, respectively)
§Patiently who underwent cervical LND showed significantly higher complication rates (0.036)
§Other laboratory findings as well as pathologic results showed no statistical significances between those two groups
§In hospital mortality; 2
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Complications
Conclusion
Minimally invasive esophageal surgery for esophageal cancer could be feasibly performed even in advanced cases. Postoperative pneumonia should be carefully managed to prevent postoperative mortality.
