281. TOTAL LAPAROSCOPIC VERSUS OPEN GASTRIC PULL-UP FOLLOWING MINIMALLY INVASIVE THORACOSCOPIC ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

Abstract

Abstract Backgroud The use of minimally invasive esophagectomy (MIE) as a treatment for patients with esophageal cancer has recently become more common worldwide. However, the laparoscopic approach for reconstruction and abdominal lymph node dissection has not fully investigated. The aim of the present study was to evaluate the technical feasibility of alimentary tract reconstruction with laparoscopically assisted gastric pull-up compared with open laparotomy gastric pull-up following minimally invasive thoracoscopic esophagectomy. Methods 63 esophageal cancer patients who underwent minimally invasive thoracoscopic esophagectomy between 2011 and 2020 were included in the present study. For reconstruction, 25 patients underwent open laparotomy gastric pull-up (OLG) while 38 patients underwent laparoscopically assisted gastric pull-up (LAG). We compared the outcomes between the two groups. Results No significant difference was observed in physical and tumor status between the two groups. The mean operative time was significantly longer in LAG group (549 vs 621 min, p = 0.010) and blood loss was significantly lower in LAG (561 vs 134 mL, p < 0.001). The mean number of harvested lymph nodes (47.2 vs 46.2, p = 0.840) were similar. The postoperative course showed lower incidences of overall complications (64% vs 32%, p = 0.011). No difference was observed in each complication between the two groups. Conclusions The findings suggest that laparoscopically assisted gastric pull-up is feasible and more effective in preventing postoperative complications.