PS02.016: MINIMALLY INVASIVE ESOPHAGECTOMY IN ESOPHAGEAL CANCER: EXPERIENCE IN THE FIRST 100 CASES

Abstract

Abstract Background In this study, the efficiency of minimally invasive esophagectomy in esophageal cancer was examined. Methods A total of 100 consecutive patients who were hospitalized due to esophageal cancer and planned minimally invasive esophagectomy were evaluated prospectively between September 2013 and December 2017 in our clinic. Laparoscopic and thoracoscopic esophagectomy was performed in all of the patients included in the study. Inoperable cases were not included in the study. Age and sex of the patients, symptoms, localization of tumor, histopathological type, surgical modality, operation time, length of hospital stay and morbidity and mortality rates were reviewed. Results Thirty-eight (38%) patients were male and 62 (62%) patients were female. The mean age was 55.5 ± 10.8 (32–75 years). The most symptoms were dysphagy (96%) and weight loss (39%). Eighty-one patients (81%) had squamous cell cancer, ten (10%) had adenocarcinoma and nine had another form of esophageal cancer. Neoadjuvant chemoradiotherapy was performed in 36 of the 100 patients. Laparoscopic and thoracoscopic esophagectomy and intrathoracic anastomosis were performed in 94 patients (94%). Laparoscopic and thoracoscopic esophagectomy and neck anastomosis were performed in six patients (6%). The mean duration of operation was 260.1 ± 33.4 minutes (185–335 minutes). The mean intraoperative blood loss was 114.2 ± 191.4 ml (10–800 ml). In 51 (51%) of the patients, complications occurred in perioperative, early postoperative and late postoperative periods. In postoperative complications, anastomotic leak rate was eight patients (8%) and pulmonary complication rate was 21 patients (21%). While mortality was seen in three patients that had diabetes mellitus and hypertension, the 30-day mortality was 2% and the hospital mortality was 3%. The mean hospital stay was 11.2 ± 8.3 days (range 8–44). In our study, the probability of one-year overall survival was 91% and the probability of two years overall survival was 66%. Conclusion Minimally invasive esophagectomy is a safe and preferred method with low mortality, acceptable morbidity, short operative time and short hospital stay and has become a routine approach in the treatment of esophageal cancers. Multicenter studies to be performed in the near future will further assist in defining the benefits of minimally invasive esophagectomy. Disclosure All authors have declared no conflicts of interest.