The Comparison of Outcomes between Video-assisted Thoracscopic and Open Surgery for Esophageal Cancer

Background: Minimally invasive esophagectomy theoretically has advantages over open esophagectomy. The purpose of the present study was to compare the short- and long-term outcomes of patients who underwent video-assisted thoracoscopic esophagectomy (VATE) or conventional open esophagectomy (OE) for esophageal carcinoma.Methods: A total of 122 patients who underwent radical esophagectomy via VATE (VATE group, N = 87) and OE (OE group, N = 35) for esophageal carcinoma between 2005 and 2018 were retrospectively enrolled in this study, and the postoperative outcomes were compared.Results: The OE group had younger patients and more patients who received neo-adjuvant therapy that the VATE group. The procedure time in the OE group was also shorter than that in the VATE group (8.22 vs. 10.28 h, P < 0.001). Intraoperative blood loss was similar between the groups (P = 0.775). There were no significant differences in the total number of dissected lymph nodes between the groups (OE: 33, VATE: 37, P = 0.482). The incidence of severe complications was lower in the VATE group than in the OE group (44.8% vs. 65.7%, P = 0.037). With a median follow-up of 26 months, the 3-year overall survival and disease-free survival were similar between the two groups.Conclusion: VATE for esophageal carcinoma is associated with more favorable short-term outcomes and equal oncological outcomes compared with OE.