Oncologic outcomes in minimally invasive esophagectomy for esophageal carcinoma

Abstract

: Esophagectomy, with clear surgical margins and appropriate lymph node dissection, is the mainstay of curative intent treatment in esophageal cancer. Minimally invasive esophagectomy (MIE) including total MIE, hybrid and robotic approaches has become more frequent. Whether or not MIE offers the same oncologic outcomes as open esophagectomy (OE) is an unanswered question to be addressed in this review. A literature review was conducted using the search terms esophageal cancer, esophagectomy, outcomes, minimally invasive surgery, survival, lymph node assessment. Relevant studies were identified by two of the authors (NAD and GED). Studies reporting short terms outcomes consistently report decreased frequency of pneumonia, decreased blood loss and shorter length of stay. Margin status, appears to be similar while lymph node harvest is similar or better compared to open surgery. Overall survival (OS) is at least similar to open surgery but in several recent reports, survival after MIE is superior. Health-related quality of life (HRQOL) appears to be improved with MIE within the first 6 months but similar thereafter. MIE offers at least equivalent outcomes in terms of resection margins and lymph node harvest and long-term survival data. MIE offers earlier recovery from surgery with improved HRQOL within the first 6 months postoperatively.