Comparison of perioperative outcomes after combined thoracoscopic-laparoscopic esophagectomy and open Ivor

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Comparison of perioperative outcomes after combined thoracoscopic-laparoscopic esophagectomy and open Ivor–Lewis esophagectomy

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作者：Thai H. Pham ; Kyle A. Perry ; James P. Dolan ; Paul Schipper ; Mithran Sukumar ; Brett C. Sheppard ; John G. Hunter
关键词：Minimally invasive ; Esophagectomy ; Perioperative morbidity ; Ivor-lewis esophagectomy
刊名：The American Journal of Surgery
出版年：2010
出版时间：May 2010
年：2010
卷：199
期：5
页码：594-598
全文大小：153 K

文摘

class=""h4"">Background

Thoracoscopic-laparoscopic esophagectomy (TLE) has gained popularity in specialized centers. This study compares the perioperative outcomes of TLE and Ivor-Lewis esophagectomy (ILE).

class=""h4"">Methods

Forty-four consecutive TLEs were compared with 46 historical ILEs. Outcomes included surgical time and blood loss, hospital length of stay, 30-day mortality rate, and complications.

class=""h4"">Results

TLE took longer to perform (543 vs 437 min; P c; .01) than ILE, but produced less blood loss (407 vs 780 mL; P c; .01). The median length of stay and 30-day mortality did not differ between groups. Cardiovascular (41 % for TLE vs 30 % for ILE; P = .19) and pulmonary complications (31 % TLE vs 30 % ILE; P = 1.0) occurred frequently in both groups, but TLE patients had fewer wound complications (4 % TLE vs 17 % ILE; P = .05).

class=""h4"">Conclusions

Despite longer surgical times, TLE produced decreased intraoperative blood loss and wound complications. These findings suggest that with further technical refinement TLE may ameliorate the morbidity seen with ILE.