Comparison of perioperative outcomes after combined thoracoscopic-laparoscopic esophagectomy and open Ivor–Lewis esophagectomy

Pham, Thai H.; Perry, Kyle A.; Dolan, James P.; Schipper, Paul; Sukumar, Mithran; Sheppard, Brett C.; Hunter, John G.

doi:10.1016/j.amjsurg.2010.01.005

« Previous Next »The American Journal of Surgery
Volume 199, Issue 5 , Pages 594-598, May 2010

Comparison of perioperative outcomes after combined thoracoscopic-laparoscopic esophagectomy and open Ivor–Lewis esophagectomy

Presented at the Annual Meeting of the North Pacific Surgical Association, November 13–15, 2009, Portland, OR.

Thai H. Pham, M.D.
- Department of Surgery, Oregon Health and Science University, M/C L223A, 3181 Sam Jackson Park Rd., Portland, OR 97239, USA
Kyle A. Perry, M.D.
- Department of Surgery, Ohio State University, Columbus, OH, USA
James P. Dolan, M.D.
- Department of Surgery, Oregon Health and Science University, M/C L223A, 3181 Sam Jackson Park Rd., Portland, OR 97239, USA
Paul Schipper, M.D.
- Department of Surgery, Oregon Health and Science University, M/C L223A, 3181 Sam Jackson Park Rd., Portland, OR 97239, USA
Mithran Sukumar, M.D.
- Department of Surgery, Oregon Health and Science University, M/C L223A, 3181 Sam Jackson Park Rd., Portland, OR 97239, USA
Brett C. Sheppard, M.D.
- Department of Surgery, Oregon Health and Science University, M/C L223A, 3181 Sam Jackson Park Rd., Portland, OR 97239, USA
- Corresponding author. Tel.: +1-503-494-7184; fax: +1-503-494-8884
John G. Hunter, M.D.
- Department of Surgery, Oregon Health and Science University, M/C L223A, 3181 Sam Jackson Park Rd., Portland, OR 97239, USA

Received 17 November 2009; received in revised form 21 January 2010

Abstract

Background

Thoracoscopic-laparoscopic esophagectomy (TLE) has gained popularity in specialized centers. This study compares the perioperative outcomes of TLE and Ivor-Lewis esophagectomy (ILE).

Methods

Forty-four consecutive TLEs were compared with 46 historical ILEs. Outcomes included surgical time and blood loss, hospital length of stay, 30-day mortality rate, and complications.

Results

TLE took longer to perform (543 vs 437 min; P < .01) than ILE, but produced less blood loss (407 vs 780 mL; P < .01). The median length of stay and 30-day mortality did not differ between groups. Cardiovascular (41% for TLE vs 30% for ILE; P = .19) and pulmonary complications (31% TLE vs 30% ILE; P = 1.0) occurred frequently in both groups, but TLE patients had fewer wound complications (4% TLE vs 17% ILE; P = .05).

Conclusions

Despite longer surgical times, TLE produced decreased intraoperative blood loss and wound complications. These findings suggest that with further technical refinement TLE may ameliorate the morbidity seen with ILE.

Keywords: Minimally invasive, Esophagectomy, Perioperative morbidity, Ivor-lewis esophagectomy