The use of a tailored surgical technique for minimally invasive esophagectomy
Objective Uncertainty exists among surgeons as to whether minimally invasive esophagectomy (MIE) is a comparable operation to open esophagectomy (OE). The surgical technique and oncologic dissection should not be degraded when using a minimally invasive approach. Methods We reviewed a single hospita...
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creator | Javidfar, Jeffrey, MD Bacchetta, Matthew, MD Yang, Jonathan A., MD, MPH Miller, Joanna, BS D’Ovidio, Frank, MD, PhD Ginsburg, Mark E., MD Gorenstein, Lyall A., MD Bessler, Marc, MD Sonett, Joshua R., MD |
description | Objective Uncertainty exists among surgeons as to whether minimally invasive esophagectomy (MIE) is a comparable operation to open esophagectomy (OE). The surgical technique and oncologic dissection should not be degraded when using a minimally invasive approach. Methods We reviewed a single hospital’s experience with both OE and MIE. From 2000 to 2010, 257 patients underwent esophagectomy by 1 of 3 surgical techniques: transhiatal, Ivor Lewis, or 3-hole. Results Of the 257 patients (median age, 67 years; range, 58–74), 92 underwent MIE. Both groups were comparable in terms of gender, age, comorbidities, surgical technique, and induction chemotherapy and radiotherapy. The overall median follow-up was 29.5 months (range, 9.9–61.5). The MIE group had a significantly shorter operative time (MIE vs OE, 330 vs 365 minutes, P = .04), length of stay (MIE vs OE, 9 vs 12 days, P |
doi_str_mv | 10.1016/j.jtcvs.2012.01.071 |
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The surgical technique and oncologic dissection should not be degraded when using a minimally invasive approach. Methods We reviewed a single hospital’s experience with both OE and MIE. From 2000 to 2010, 257 patients underwent esophagectomy by 1 of 3 surgical techniques: transhiatal, Ivor Lewis, or 3-hole. Results Of the 257 patients (median age, 67 years; range, 58–74), 92 underwent MIE. Both groups were comparable in terms of gender, age, comorbidities, surgical technique, and induction chemotherapy and radiotherapy. The overall median follow-up was 29.5 months (range, 9.9–61.5). The MIE group had a significantly shorter operative time (MIE vs OE, 330 vs 365 minutes, P = .04), length of stay (MIE vs OE, 9 vs 12 days, P < .01), intensive care unit admission rate (MIE vs OE, 55% vs 81%, P < .01), intensive care unit length of stay (MIE vs OE, 1 vs 2 days, P < .01), and estimated blood loss (MIE vs OE, 100 vs 400 mL, P < .01). More lymph nodes were harvested in the MIE group than in the OE group (17 vs 11 nodes, P < .01). There were insignificant differences in 30-day mortality (MIE vs OE, 2.2% vs 3.0%; P = .93) and overall survival ( P = .19), as well as in the rates of all complications, except pneumonia (MIE vs OE, 2% vs 13%; P = .01). Conclusions A thoracic surgeon can safely tailor the MIE to a patient’s anatomy and oncologic demands while maintaining equivalent survival.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2012.01.071</identifier><identifier>PMID: 22500593</identifier><identifier>CODEN: JTCSAQ</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Carcinoma, Squamous Cell - mortality ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - surgery ; Cardiology. Vascular system ; Cardiothoracic Surgery ; Chi-Square Distribution ; Esophageal Neoplasms - mortality ; Esophageal Neoplasms - pathology ; Esophageal Neoplasms - surgery ; Esophagectomy - adverse effects ; Esophagectomy - methods ; Esophagectomy - mortality ; Female ; Humans ; Kaplan-Meier Estimate ; Lymph Node Excision ; Male ; Medical sciences ; Middle Aged ; Minimally Invasive Surgical Procedures ; New York City ; Pneumology ; Postoperative Complications - etiology ; Retrospective Studies ; Stomach, duodenum, intestine, rectum, anus ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Time Factors ; Treatment Outcome</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2012-05, Vol.143 (5), p.1125-1129</ispartof><rights>The American Association for Thoracic Surgery</rights><rights>2012 The American Association for Thoracic Surgery</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c489t-cff1208674bab054e7218ffbb9269f7d3ec2b88bbb843b501c7153f38e3c45163</citedby><cites>FETCH-LOGICAL-c489t-cff1208674bab054e7218ffbb9269f7d3ec2b88bbb843b501c7153f38e3c45163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jtcvs.2012.01.071$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>315,782,786,3554,27933,27934,46004</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25878092$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22500593$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Javidfar, Jeffrey, MD</creatorcontrib><creatorcontrib>Bacchetta, Matthew, MD</creatorcontrib><creatorcontrib>Yang, Jonathan A., MD, MPH</creatorcontrib><creatorcontrib>Miller, Joanna, BS</creatorcontrib><creatorcontrib>D’Ovidio, Frank, MD, PhD</creatorcontrib><creatorcontrib>Ginsburg, Mark E., MD</creatorcontrib><creatorcontrib>Gorenstein, Lyall A., MD</creatorcontrib><creatorcontrib>Bessler, Marc, MD</creatorcontrib><creatorcontrib>Sonett, Joshua R., MD</creatorcontrib><title>The use of a tailored surgical technique for minimally invasive esophagectomy</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Objective Uncertainty exists among surgeons as to whether minimally invasive esophagectomy (MIE) is a comparable operation to open esophagectomy (OE). The surgical technique and oncologic dissection should not be degraded when using a minimally invasive approach. Methods We reviewed a single hospital’s experience with both OE and MIE. From 2000 to 2010, 257 patients underwent esophagectomy by 1 of 3 surgical techniques: transhiatal, Ivor Lewis, or 3-hole. Results Of the 257 patients (median age, 67 years; range, 58–74), 92 underwent MIE. Both groups were comparable in terms of gender, age, comorbidities, surgical technique, and induction chemotherapy and radiotherapy. The overall median follow-up was 29.5 months (range, 9.9–61.5). The MIE group had a significantly shorter operative time (MIE vs OE, 330 vs 365 minutes, P = .04), length of stay (MIE vs OE, 9 vs 12 days, P < .01), intensive care unit admission rate (MIE vs OE, 55% vs 81%, P < .01), intensive care unit length of stay (MIE vs OE, 1 vs 2 days, P < .01), and estimated blood loss (MIE vs OE, 100 vs 400 mL, P < .01). More lymph nodes were harvested in the MIE group than in the OE group (17 vs 11 nodes, P < .01). There were insignificant differences in 30-day mortality (MIE vs OE, 2.2% vs 3.0%; P = .93) and overall survival ( P = .19), as well as in the rates of all complications, except pneumonia (MIE vs OE, 2% vs 13%; P = .01). Conclusions A thoracic surgeon can safely tailor the MIE to a patient’s anatomy and oncologic demands while maintaining equivalent survival.</description><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Squamous Cell - mortality</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Cardiology. Vascular system</subject><subject>Cardiothoracic Surgery</subject><subject>Chi-Square Distribution</subject><subject>Esophageal Neoplasms - mortality</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Esophagectomy - adverse effects</subject><subject>Esophagectomy - methods</subject><subject>Esophagectomy - mortality</subject><subject>Female</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Lymph Node Excision</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgical Procedures</subject><subject>New York City</subject><subject>Pneumology</subject><subject>Postoperative Complications - etiology</subject><subject>Retrospective Studies</subject><subject>Stomach, duodenum, intestine, rectum, anus</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUGL1DAUx4so7uzqJxAkF8FL60vStOlBQRZXhRUPruAtJOnLTmrbjEk7MN_ejDMqePGUy--f997vXxTPKFQUaPNqqIbF7lPFgLIKaAUtfVBsKHRt2Ujx7WGxAWCsFIzxi-IypQEAWqDd4-KCMQEgOr4pPt1tkawJSXBEk0X7MUTsSVrjvbd6JAva7ex_rEhciGTys5_0OB6In_c6-T0STGG31fdolzAdnhSPnB4TPj2_V8XXm3d31x_K28_vP16_vS1tLbultM5RBrJpa6MNiBpbRqVzxnSs6Vzbc7TMSGmMkTU3AqhtqeCOS-S2FrThV8XL07-7GPJuaVGTTxbHUc8Y1qQo5DsF62rIKD-hNoaUIjq1i_mGeMiQOnpUg_rlUR09KqAqe8yp5-cBq5mw_5P5LS4DL86ATtmTi3q2Pv3lhGwldCxzr08cZh17j1El63G22PuYnak--P8s8uafvB1zCXnkdzxgGsIa52xaUZVyRn05Vn5sPPsF2oLgPwEHVqbI</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Javidfar, Jeffrey, MD</creator><creator>Bacchetta, Matthew, MD</creator><creator>Yang, Jonathan A., MD, MPH</creator><creator>Miller, Joanna, BS</creator><creator>D’Ovidio, Frank, MD, PhD</creator><creator>Ginsburg, Mark E., MD</creator><creator>Gorenstein, Lyall A., MD</creator><creator>Bessler, Marc, MD</creator><creator>Sonett, Joshua R., MD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120501</creationdate><title>The use of a tailored surgical technique for minimally invasive esophagectomy</title><author>Javidfar, Jeffrey, MD ; Bacchetta, Matthew, MD ; Yang, Jonathan A., MD, MPH ; Miller, Joanna, BS ; D’Ovidio, Frank, MD, PhD ; Ginsburg, Mark E., MD ; Gorenstein, Lyall A., MD ; Bessler, Marc, MD ; Sonett, Joshua R., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-cff1208674bab054e7218ffbb9269f7d3ec2b88bbb843b501c7153f38e3c45163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Squamous Cell - mortality</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Cardiology. Vascular system</topic><topic>Cardiothoracic Surgery</topic><topic>Chi-Square Distribution</topic><topic>Esophageal Neoplasms - mortality</topic><topic>Esophageal Neoplasms - pathology</topic><topic>Esophageal Neoplasms - surgery</topic><topic>Esophagectomy - adverse effects</topic><topic>Esophagectomy - methods</topic><topic>Esophagectomy - mortality</topic><topic>Female</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Lymph Node Excision</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgical Procedures</topic><topic>New York City</topic><topic>Pneumology</topic><topic>Postoperative Complications - etiology</topic><topic>Retrospective Studies</topic><topic>Stomach, duodenum, intestine, rectum, anus</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Javidfar, Jeffrey, MD</creatorcontrib><creatorcontrib>Bacchetta, Matthew, MD</creatorcontrib><creatorcontrib>Yang, Jonathan A., MD, MPH</creatorcontrib><creatorcontrib>Miller, Joanna, BS</creatorcontrib><creatorcontrib>D’Ovidio, Frank, MD, PhD</creatorcontrib><creatorcontrib>Ginsburg, Mark E., MD</creatorcontrib><creatorcontrib>Gorenstein, Lyall A., MD</creatorcontrib><creatorcontrib>Bessler, Marc, MD</creatorcontrib><creatorcontrib>Sonett, Joshua R., MD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Javidfar, Jeffrey, MD</au><au>Bacchetta, Matthew, MD</au><au>Yang, Jonathan A., MD, MPH</au><au>Miller, Joanna, BS</au><au>D’Ovidio, Frank, MD, PhD</au><au>Ginsburg, Mark E., MD</au><au>Gorenstein, Lyall A., MD</au><au>Bessler, Marc, MD</au><au>Sonett, Joshua R., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The use of a tailored surgical technique for minimally invasive esophagectomy</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>143</volume><issue>5</issue><spage>1125</spage><epage>1129</epage><pages>1125-1129</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><coden>JTCSAQ</coden><abstract>Objective Uncertainty exists among surgeons as to whether minimally invasive esophagectomy (MIE) is a comparable operation to open esophagectomy (OE). The surgical technique and oncologic dissection should not be degraded when using a minimally invasive approach. Methods We reviewed a single hospital’s experience with both OE and MIE. From 2000 to 2010, 257 patients underwent esophagectomy by 1 of 3 surgical techniques: transhiatal, Ivor Lewis, or 3-hole. Results Of the 257 patients (median age, 67 years; range, 58–74), 92 underwent MIE. Both groups were comparable in terms of gender, age, comorbidities, surgical technique, and induction chemotherapy and radiotherapy. The overall median follow-up was 29.5 months (range, 9.9–61.5). The MIE group had a significantly shorter operative time (MIE vs OE, 330 vs 365 minutes, P = .04), length of stay (MIE vs OE, 9 vs 12 days, P < .01), intensive care unit admission rate (MIE vs OE, 55% vs 81%, P < .01), intensive care unit length of stay (MIE vs OE, 1 vs 2 days, P < .01), and estimated blood loss (MIE vs OE, 100 vs 400 mL, P < .01). More lymph nodes were harvested in the MIE group than in the OE group (17 vs 11 nodes, P < .01). There were insignificant differences in 30-day mortality (MIE vs OE, 2.2% vs 3.0%; P = .93) and overall survival ( P = .19), as well as in the rates of all complications, except pneumonia (MIE vs OE, 2% vs 13%; P = .01). Conclusions A thoracic surgeon can safely tailor the MIE to a patient’s anatomy and oncologic demands while maintaining equivalent survival.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>22500593</pmid><doi>10.1016/j.jtcvs.2012.01.071</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - surgery Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Carcinoma, Squamous Cell - mortality Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery Cardiology. Vascular system Cardiothoracic Surgery Chi-Square Distribution Esophageal Neoplasms - mortality Esophageal Neoplasms - pathology Esophageal Neoplasms - surgery Esophagectomy - adverse effects Esophagectomy - methods Esophagectomy - mortality Female Humans Kaplan-Meier Estimate Lymph Node Excision Male Medical sciences Middle Aged Minimally Invasive Surgical Procedures New York City Pneumology Postoperative Complications - etiology Retrospective Studies Stomach, duodenum, intestine, rectum, anus Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Time Factors Treatment Outcome |
title | The use of a tailored surgical technique for minimally invasive esophagectomy |
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