Related Experiment Video
Updated: Nov 16, 2025
An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Feasibility of enhanced recovery protocol in minimally invasive McKeown esophagectomy
Yuichiro Tanishima1, Katsunori Nishikawa2, Masami Yuda2
1Division of Gastrointestinal Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan. tanishima@jikei.ac.jp.
Background:
Implementation of enhanced recovery after surgery has generally been applied to gastrointestinal surgeries; however, few studies have investigated minimally invasive McKeown esophagectomy. In this study, we aimed to evaluate the safety and feasibility of an enhanced recovery protocol after minimally invasive McKeown esophagectomy.
Methods:
Data were collected between January 2015 and April 2020 for patients who underwent esophagectomy. Of these patients, those who underwent minimally invasive McKeown esophagectomy was selected for the investigation. Perioperative outcomes and nutritional index were compared using propensity score matching between the conventional group and the enhanced recovery group.
Results:
A total of 119 patients were enrolled in this study. Of these, 73 and 46 were treated with conventional and enhanced recovery protocol, respectively. Forty-two pairs were matched in two groups. The enhanced recovery group showed a lower rate of pulmonary complications (9.5% vs. 28.5%, p = 0.0235), abdominal dysfunctions (16.7% vs. 42.9%, p = 0.0078), and shorter hospital stay as compared with the conventional group (17.5 days vs. 23 days, p = 0.0034). The loss of body weight (6.3% vs. 7.7%, p = 0.0065) and body mass index (5.6% vs. 8.1%, p = 0.0017) were significantly lower in the enhanced recovery group than in the conventional group. In contrast, nutritional biochemistry data did not differ significantly between the two groups.
Conclusions:
This study shows that the promotion of an enhanced recovery protocol in minimally invasive McKeown esophagectomy maintains nutritional status without increasing postoperative complications.
Insights
Enhanced recovery protocols in minimally invasive McKeown esophagectomy reduce complications and hospital stays. This approach safely maintains patient nutritional status post-surgery.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Enhanced Recovery Protocols
Background:
- Enhanced recovery after surgery (ERAS) protocols are established for gastrointestinal surgeries.
- Limited research exists on ERAS application in minimally invasive McKeown esophagectomy.
Purpose of the Study:
- To evaluate the safety and feasibility of an enhanced recovery protocol.
- To assess outcomes of ERAS in minimally invasive McKeown esophagectomy.
Main Methods:
- Retrospective analysis of esophagectomy patients (Jan 2015 - Apr 2020).
- Comparison of perioperative outcomes and nutritional index between conventional and ERAS groups.
- Propensity score matching used for group comparison.
Main Results:
- ERAS group showed significantly lower pulmonary complications (9.5% vs 28.5%) and abdominal dysfunctions (16.7% vs 42.9%).
- Hospital stay was shorter in the ERAS group (17.5 vs 23 days).
- Reduced body weight and BMI loss observed in the ERAS group, with no significant difference in nutritional biochemistry.
Conclusions:
- Enhanced recovery protocols are safe and feasible for minimally invasive McKeown esophagectomy.
- ERAS implementation maintains nutritional status while reducing postoperative complications.
