P-0139 - Minimally invasive esophagectomy: the new paradigm?

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Oesophageal Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Hugo Santos-Sousa
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors H. Santos-Sousa, E. Lima-da-Costa, J. Preto, A. Gouveia, S. Carneiro, J. Barbosa, J. Costa-Maia
  • Centro Hospitalar de São João, University of Porto Medical School, Porto/PT

Abstract

Introduction

Esophagectomy is a major surgery associated with significant morbidity and mortality. There is growing evidence in literature that the minimally invasive approach in esophagectomy (MIE) may decrease morbidity.

Methods

Analysis of a prospective database with esophageal cancer cases submitted to curative intent surgery, between January 2011 and October 2013. For this analysis, cases of open or non-resectional surgery were excluded.

Results

From the initial population (n = 32), 20 cases (12 MIE and 8 hybrid approach) were included. There was a male predominance (80%), with a median age of 62 [43-78] years. Most tumors were squamous cell carcinomas (75%), from the lower third (65%), T3 (70.6%), submitted to neoadjuvant treatment (68.4%). There was a predominance of Ivor-Lewis esophagectomy (75%) and there were 2 conversions. In all cases the resection was R0, with a median of 14 [6-48] lymph nodes retrieved. The mean operative time was 507.2 ± 17.7 minutes and the median post-operative length of stay was 12.5 [4-79] days. Morbidity was observed in 6 cases and the post-operative mortality was 5% (1 case of ARDS). The median follow-up was 8 [0-32] months. The overall survival was 69%, with a mean survival of 23.5 ± 3.1 months.

Conclusion

MIE has a significant learning curve, but appears to be safe and to have good oncological outcomes when performed in differentiated centers.