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Updated: Aug 4, 2026
An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Minimally invasive esophagectomy for esophageal cancer: the first experience from Pakistan
Farrukh Hassan Rizvi1, Syed Shahrukh Hassan Rizvi1, Aamir Ali Syed1
1Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital, House No. 164, Lane No. 7, J-3 Block Wapda Town Phase 1, Lahore 54000, Pakistan.
Background:
Two common procedures for esophageal resection are Ivor Lewis esophagectomy and transhiatal esophagectomy. Both procedures have high morbidity rates of 20-46%. Minimally invasive esophagectomy has been introduced to decrease morbidity. We report initial experience of MIE to determine the morbidity and mortality associated with this procedure during learning phase.
Material And Methods:
Patients undergoing MIE at our institute from January 2011 to May 2013 were reviewed. Record was kept for any morbidity and mortality. Descriptive statistics were presented as frequencies and continuous variables were presented as median. Survival analysis was performed using Kaplan Meier curves.
Results:
We performed 51 minimally invasive esophagectomies. Perioperative morbidity was in 16 (31.37%) patients. There were 3 (5.88%) anastomotic leaks. We encountered 1 respiratory complication. Reexploration was required in 3 (5.88%) patients. Median operative time was 375 minutes. Median hospital stay was 10 days. The most frequent long-term morbidity was anastomotic narrowing observed in 5 (9.88%) patients. There were no perioperative mortalities. Our mean overall survival was 37.66 months (95% confidence interval 33.75 to 41.56 months). Mean disease-free survival was 24.43 months (95% CI 21.26 to 27.60 months).
Conclusion:
Minimally invasive esophagectomy, when performed in the learning phase, has acceptable morbidity and mortality.
