The efficiency of minimally invasive esophagectomy in esophageal cancer

In this study, the efficiency of minimally invasive esophagectomy in esophageal cancer was examined. A total of 75 consecutive patients who were hospitalized due to esophageal cancer and planned minimally invasive esophagectomy were evaluated prospectively between September 2013 and January 2017 in our clinic. Seven patients who were considered as unrezectable, intraoperatively, were excluded from the study. Minimally invasive esophagectomy was performed in all of the patients included in the study. Twenty four (35.3%) patients were male and 44 (64.7%) patients were female. The mean age was 55.2±10.2 (32-75 years). The most symptoms were dysphagy (95.5%) and weight loss (38.23%). Fifty four patients (79.41%) had squamous cell cancer, five (7.35%) had adenocarcinoma and nine had another form of esophageal cancer. Minimally invasive esophagectomy intrathoracic anastomosis was performed in 63 patients (92.6%), and minimally invasive esophagectomy neck anastomosis was performed in five patients (7.4%). Neoadjuvant chemoradiotherapy was performed in 23 (33.8%) of the 68 patients. The mean duration of operation was 262.7 ± 32.9 minutes (195-330 minutes). The mean intraoperative blood loss was 115.07 ± 190.68 ml (10-800 ml). In 36 (52.9%) of the patients, complications occurred in peroperative, early postoperative and late postoperative periods. In postoperative complications, anastomotic leak rate was 13.2%(seven patients) and pulmonary complication rate was 22.05%(15 patients). While mortality was seen in two patients that had diabetes mellitus and hypertension, the 30-day mortality was 1.47%and the hospital mortality was 2.9%. The mean hospital stay was 11.3 ± 8.4 days (range 8-44). The mean survival time was 31.50 ± 1.99 months. In our study, the probability of one year overall survival was 89.77% and the probability of two years overall survival was 64.2%. 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.