Comparison of minimally invasive esophagectomy with transthoracic and transhiatal esophagectomy.
OBJECTIVE
Minimally invasive esophagectomy can be performed as safely as conventional esophagectomy and has distinct perioperative outcome advantages.


METHODS
A retrospective comparison of 3 methods of esophagectomy: minimally invasive, transthoracic, and blunt transhiatal.


METHODS
University medical center.


METHODS
Eighteen consecutive patients underwent combined thoracoscopic and laparoscopic esophagectomy from October 9, 1998, through January 19, 2000. These patients were compared with 16 patients who underwent transthoracic esophagectomy and 20 patients who underwent blunt transhiatal esophagectomy from June 1, 1993, through August 5, 1998.


METHODS
Operative time, amount of blood loss, number of operative transfusions, length of intensive care and hospital stays, complications, and mortality.


RESULTS
Patients who had minimally invasive esophagectomy had shorter operative times, less blood loss, fewer transfusions, and shortened intensive care unit and hospital courses than patients who underwent transthoracic or blunt transhiatal esophagectomy. There was no significant difference in the incidence of anastomotic leak or respiratory complications among the 3 groups.


CONCLUSIONS
Minimally invasive esophagectomy is safe and provides clinical advantages compared with transthoracic and blunt transhiatal esophagectomy.
Nguyen
N T
NT
Department of Surgery, University of California, Davis, Medical Center, 2221 Stockton Blvd, Third Floor, Sacramento, CA 95817-1418, USA. ninh.nguyen@ucdmc.ucdavis.edu
Follette
D M
DM
Wolfe
B M
BM
Schneider
P D
PD
Roberts
P
P
Goodnight
J E
JE
D000368:Aged; D000704:Analysis of Variance; D000714:Anastomosis, Surgical / Q000009:adverse effects; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D016009:Chi-Square Distribution; D003422:Critical Care; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D011183:Postoperative Complications; D012131:Respiratory Insufficiency / Q000209:etiology; D012189:Retrospective Studies; D012449:Safety; D015996:Survival Rate; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods; D013997:Time Factors