Minimally Invasive Esophagectomy for Achieving R0

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Esophageal Cancer Treatment

Background:

• Minimally invasive esophagectomy (MIE) is gaining popularity for esophageal cancer.
• Debate exists regarding its safety and efficacy compared to open esophagectomy (OE).
• Focus on oncologic outcomes, specifically margin status and nodal retrieval, is crucial.

Purpose of the Study:

• To compare the oncologic outcomes of MIE versus OE.
• Specifically evaluate differences in margin status (R0 resection) and lymph node retrieval.
• Provide evidence to support the use of MIE in esophageal cancer treatment.

Main Methods:

• Retrospective review of 93 patients with esophageal cancer (2013-2018).
• Patients underwent either MIE (76) or OE (17).
• Comparison of histological type, tumor grade, staging (cTNM, pTNM, ypTNM), and lymph node retrieval.

Main Results:

• MIE group showed a statistically significant improvement in R0 resection margins compared to OE.
• No significant differences were observed in clinical staging, pathological staging, tumor grade, or nodal retrieval.
• Neoadjuvant therapy (NAT) use did not significantly differ between groups.

Conclusions:

• MIE demonstrates superior oncologic outcomes, specifically improved R0 margin rates, compared to OE.
• These findings support MIE as a viable and potentially superior surgical approach for esophageal cancer.
• MIE's established short-term surgical benefits are complemented by these oncologic advantages.