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Abstract
Abstract Background Ivor Lewis Oesophagogastrectomy (ILO) is a potentially curative but highly morbid surgery. Minimally invasive techniques by comparison have demonstrated improved post-operative outcomes for patients. Hybrid laparoscopic gastric mobilisation (LGM) combined with an open right thoracotomy was introduced in our centre in 2019. This study assessed oncological outcomes between ILO with LGM and a fully open ILO, following this local change in operative technique. Methods This was a retrospective study of patients undergoing ILO at a single tertiary unit over a 5-year period (2017–2021). All patients undergoing open ILO were compared with those who had ILO with LGM. Resected lymph node count was used as a marker for oncological outcomes and median length of hospital stay a marker for post-operative outcomes. Results During the study period, 42 patients had open ILO and 32 had ILO with LGM. Patient demographics were similar between groups, with the majority receiving neoadjuvant chemotherapy (Open ILO 92.9% vs LGM 96.9%, p=0.629). Following local introduction of LGM in 2019, it immediately became the predominant method of gastric mobilisation during ILO (58% cases in 2019; 100% cases in 2020; 73% cases in 2021). Median total lymph node count resected was similar between LGM 17(15–25) vs open ILO 18 (16–24), p=0.643. Overall, length of stay was shorter in those having LGM compared to open (16 (11–21) vs 18 (11–36)), although this did not reach statistical significance (p=0.129). Conclusions Introduction of a hybrid minimally invasive technique for oesophagogastrectomy within our regional centre, has been associated with similar oncological outcomes to the traditional open approach. Further evaluation is required to ascertain the potential patient benefits of a LGM on post-operative outcomes within our patient cohort.
Published Version
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