Outcomes With Open and Minimally Invasive Ivor Lewis Esophagectomy After Neoadjuvant Therapy.

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Thoracic Surgery

Background:

• Neoadjuvant therapy is standard for locally advanced esophageal cancer.
• Concerns exist regarding safety and oncologic outcomes of minimally invasive esophagectomy (MIE) after neoadjuvant treatment.
• This study compares open and MIE Ivor Lewis esophagectomy following neoadjuvant therapy.

Purpose of the Study:

• To evaluate the safety and oncologic outcomes of minimally invasive esophagectomy (MIE) versus open esophagectomy after neoadjuvant therapy for esophageal cancer.
• To compare postoperative complications, length of stay, and survival rates between the two surgical approaches.

Main Methods:

• Retrospective analysis of 130 patients with esophageal cancer undergoing Ivor Lewis esophagectomy.
• Patients received neoadjuvant therapy prior to either open or minimally invasive (MIE) surgery.
• Outcomes analyzed include postoperative complications, length of stay, and survival.

Main Results:

• Minimally invasive esophagectomy (MIE) was associated with shorter intensive care unit and hospital stays.
• Respiratory complications were significantly lower in the MIE group (8.9%) compared to open surgery (29.7%).
• Postoperative complications, anastomotic leak rates, 30/90-day mortality, complete resection rates, lymph node yield, and 5-year overall survival were similar between open and MIE groups.

Conclusions:

• Minimally invasive esophagectomy (MIE) is safe and effective following neoadjuvant therapy for esophageal cancer.
• MIE facilitates faster early recovery and reduces pulmonary complications compared to open surgery.
• Both MIE and open esophagectomy demonstrate comparable perioperative oncologic outcomes, though long-term results warrant further investigation.