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Minimally Invasive Esophagectomy: Outcomes in 222 Patients

Open access
Luketich, James D., Alvelo-Rivera, Miguel, Buenaventura, Percival O., Christie, Neil A., McCaughan, James S., Litle, Virginia R., Schauer, Philip R., Close, John M., Fernando, Hiran C.·2003·Annals of Surgery

Abstract

OBJECTIVE: To assess our outcomes after minimally invasive esophagectomy (MIE). SUMMARY BACKGROUND DATA: Esophagectomy has traditionally been performed by open methods. Results from most series include mortality rates in excess of 5% and hospital stays frequently greater than 10 days. MIE has the potential to improve these results, but only a few small series have been reported. This report summarizes our experience of 222 cases. METHODS: From 1996 to 2002, MIE was performed in 222 patients. Indications for operation included high-grade dysplasia (n = 47) and cancer (n = 175). Neoadjuvant chemotherapy was used in 78 (35.1%) and radiation in 36 (16.2%). Initially, a laparoscopic transhiatal approach was used (n = 8), but subsequently our approach evolved to include thoracoscopic mobilization (n = 214). RESULTS: There were 186 men and 36 women. Median age was 66.5 years (range, 39-89). Nonemergent conversion to open procedure was required in 16 patients (7.2%). MIE was successfully completed in 206 (92.8%) patients. The median intensive care unit stay was 1 day (range, 1-30); hospital stay was 7 days (range, 3-75). Operative mortality was 1.4% (n = 3). Anastomotic leak rate was 11.7% (n = 26). At a mean follow-up of 19 months (range, 1-68), quality of life scores were similar to preoperative values and population norms. Stage specific survival was similar to open series. CONCLUSIONS: MIE offers results as good as or better than open operation in our center with extensive minimally invasive and open experience. In this single institution experience, we observed a lower mortality rate (1.4%) and shorter hospital stay (7 days) than most open series. Given these results, we are now developing an intergroup trial (ECOG 2202) to assess MIE in a multicenter setting.

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Metadata

Authors
Luketich, J. D., Alvelo-Rivera, M., Buenaventura, P. O., Christie, N. A., McCaughan, J. S., Litle, V. R., Schauer, P. R., Close, J. M., & Fernando, H. C.
Venue
Annals of Surgery
Published
2003-10
Volume
238
Issue
4
Pages
486-495
ISSN
0003-4932 (ISSN-L)
OpenAlex
W2060772190
Cited by
893
References
11
FWCI
28.83
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: Minimally Invasive Esophagectomy: Outcomes in 222 Patients. https://app.cochat.ai/papers/10.1097/01.sla.0000089858.40725.68
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Luketich, J. D., Alvelo-Rivera, M., Buenaventura, P. O., Christie, N. A., McCaughan, J. S., Litle, V. R., Schauer, P. R., Close, J. M., & Fernando, H. C. (2003). Minimally Invasive Esophagectomy: Outcomes in 222 Patients. Annals of Surgery. https://doi.org/10.1097/01.sla.0000089858.40725.68

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