title: Comparison of laparoscopic inversion esophagectomy and open transhiatal esophagectomy for high-grade dysplasia and stage I esophageal adenocarcinoma.
abstract: OBJECTIVE
  The perioperative outcomes of laparoscopic inversion esophagectomy (LIE) are comparable to those of open transhiatal esophagectomy (THE), with potential benefits related to the use of minimally invasive techniques.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Tertiary care university hospital.
  
  
  METHODS
  From July 1, 2003, through March 31, 2008, 21 consecutive patients underwent LIE for high-grade dysplasia or clinical stage I esophageal cancer. We compared these patients with 21 stage-matched control patients treated with THE from August 1, 1995, through August 31, 2003.
  
  
  METHODS
  Operative time, blood loss, length of hospital stay, perioperative complications, and disease-free survival.
  
  
  RESULTS
  Mean (SD) operative times for LIE (399 [86] minutes) and THE (407 [127] minutes) were not significantly different (P = .80). Patients undergoing LIE had significantly lower intraoperative blood loss (168 mL; P < .001) and overall length of hospital stay (10 days; P = .03) compared with those in the THE group (526 mL and 14 days, respectively). Complication rates were not significantly different between the groups. With a median follow-up of 29 months, there has been 1 systemic recurrence in the LIE group.
  
  
  CONCLUSIONS
  Laparoscopic inversion esophagectomy is a safe and effective approach to the treatment of high-grade dysplasia and early esophageal adenocarcinoma. Compared with THE, LIE decreases operative blood loss and length of hospital stay without increasing the operative time, morbidity, or mortality related to esophagectomy.
authors.affiliation: Department of Surgery, Oregon Health & Science University, Portland, OR 97239, USA.
authors.forename: Kyle A
authors.initials: KA
authors.lastname: Perry
authors.forename: C Kristian
authors.initials: CK
authors.lastname: Enestvedt
authors.forename: Thai
authors.initials: T
authors.lastname: Pham
authors.forename: Melissa
authors.initials: M
authors.lastname: Welker
authors.forename: Blair A
authors.initials: BA
authors.lastname: Jobe
authors.forename: John G
authors.initials: JG
authors.lastname: Hunter
authors.forename: Brett C
authors.initials: BC
authors.lastname: Sheppard
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004943:Esophagogastric Junction; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome