[Complete minimally invasive Ivor-Lewis esophageal resection]

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Minimally invasive esophagectomy is increasingly adopted for esophageal cancer.
• The Ivor Lewis esophagectomy technique is being adapted for minimally invasive approaches.

Purpose of the Study:

• To analyze technical difficulties and intraoperative complications of thoracolaparoscopic Ivor Lewis esophagectomy with intrathoracic anastomosis.
• To evaluate postoperative complications using the Clavien-Dindo classification.

Main Methods:

• Retrospective analysis of 19 patients undergoing completely minimally invasive esophagectomy.
• Inclusion criterion: history of thoracolaparoscopic esophagectomy.
• Multidisciplinary approach for diagnosis, surgical indication, and perioperative care.

Main Results:

• 19 patients (13 male, 6 female) with adenocarcinoma underwent the procedure.
• Postoperative morbidity was 68.4%, with Grade III complications (36.8%) being most frequent.
• Anastomotic leak was the most severe complication, managed with vacuum therapy and stenting. No postoperative mortality.
• Mean hospital stay was 12 days; mean ICU stay was 3.6 days.

Conclusions:

• Thoracolaparoscopic Ivor Lewis esophagectomy with intrathoracic anastomosis is a feasible and accessible option.
• The procedure appears safe regarding technical challenges and short-term/long-term complications.
• Oncosurgical principles of radicality, functionality, safety, and cost-effectiveness must be maintained.