Clinical experience using the technique of OrVil for minimally invasive esophagectomy and esophagogastric anastomosis

Abstract

Objective To evaluate the feasibility,safety of completely minimally invasive esophagectomy and esophagogastric anastomosis by using the technique of transoral anvil (OrVil) for the treatment of middle and lower thoracic esophageal cancer.Methods We retrospectively analyzed clinical data of 53 patients with esophageal cancer who underwent completely minimally invasive esophagectomy and esophagogastric anastomosis from December 2010 to March 2013.46 patients underwent laparoscopic and thoracoscopic esophagectomy,followed by intrathoracic esophagogastric anastomosis using the technique of OrVil,and 7 patients underwent laparoscopic esophagectomy and esophagogastric anastomosis using the technique of OrVil.Results There was no perioperative or in-hospital death,no conversion to open.The mean operation time was (294.5 ± 46.8) minutes,mean intra-operative blood loss was(172.3 ± 102.1) ml,mean extubation time was(5.2 ± 2.3) days,mean time to resume oral intake was(10.1 ±4.3) days,mean postoperative hospital stay was(14.1 ±6.2) days,mean number of lymph nodes resected was (26.5 ± 9.9),mean number of mediastinal lymph nodes resected was(10.9 ± 6.6),mean number of abdominal lymph nodes resected was(15.1 ± 10.9).The major perioperative morbidity was 13.2％.One patient had anastomotic leak (1.9％),six patients had pneumonia (11.3 ％).When stratified by time period,the mean operation time and intra-operative blood loss were decreased in the late 15 cases.The median follow-up was (13.0 ± 7.3) months (range 1-27 months) in 52 patients.There was no anastomotic stricture,and the over all survival was 88.5％.Conclusion Completely minimally invasive esophagectomy and esophagogastric anastomosis by using the technique of OrVil for the treatment of middle and lower thoracic esophageal cancer is minimally invasive,afe,feasible,and with a good short-term outcomes. Key words: Esophageal neoplasms ; Surgical pocedues, minimally invasive; Esophagectomy