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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Minimally invasive esophagectomy: lessons learned from 104 operations
Ninh T Nguyen1, Marcelo W Hinojosa, Brian R Smith
1Department of Surgery, University of California, Irvine Medical Center, Orange, CA 92868, USA. ninhn@uci.edu
Annals of Surgery
|December 19, 2008
Summary
Minimally invasive esophagectomy (MIE) is a feasible surgical option for esophageal diseases, demonstrating low conversion rates and acceptable morbidity. This approach offers a safe alternative with low mortality, particularly the Ivor Lewis resection technique.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Minimally Invasive Procedures
Background:
- Minimally invasive esophagectomy (MIE) has been reported since 1992 but remains investigational at many institutions.
- Evaluating outcomes of MIE is crucial for its wider adoption in clinical practice.
Purpose of the Study:
- To review the outcomes of 104 consecutive minimally invasive esophagectomy (MIE) procedures.
- To assess the feasibility, safety, and efficacy of MIE for benign and malignant esophageal conditions.
Main Methods:
- Prospective evaluation of 104 MIE procedures performed between August 1998 and September 2007.
- Key outcome measures included operative techniques, operative times, blood loss, length of stay, conversion rates, morbidities, and mortalities.
Main Results:
- The study included 80 esophageal cancer cases and other conditions like Barrett esophagus and strictures.
- The minimally invasive Ivor Lewis resection was the preferred approach (n=51).
- Low conversion rate (2.9%), median ICU stay of 2 days, median hospital stay of 8 days, major complication rate of 12.5%, and 30-day mortality of 1.9% were observed.
Conclusions:
- Minimally invasive esophagectomy (MIE) is a feasible procedure with a low conversion rate, acceptable morbidity, and low mortality.
- The laparoscopic/thoracoscopic Ivor Lewis resection is the preferred method, facilitating a tension-free intrathoracic anastomosis.
