Universität zu Köln

van der Wilk, Berend J., Hagens, Eliza R. C., Eyck, Ben M., Gisbertz, Suzanne S., van Hillegersberg, Richard, Nafteux, Philippe, Schroder, Wolfgang, Nilsson, Magnus ORCID: 0000-0002-6215-8132, Wijnhoven, Bas P. L., Lagarde, Sjoerd M. and Henegouwen, Mark I. van Berge (2022). Outcomes after totally minimally invasive versus hybrid and open Ivor Lewis oesophagectomy: results from the International Esodata Study Group. Br. J. Surg., 109 (3). S. 283 - 291. OXFORD: OXFORD UNIV PRESS. ISSN 1365-2168

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Abstract

Background Large studies comparing totally minimally invasive oesophagectomy (TMIE) with laparoscopically assisted (hybrid) oesophagectomy are lacking. Although randomized trials have compared TMIE invasive with open oesophagectomy, daily clinical practice does not always resemble the results reported in such trials. The aim of the present study was to compare complications after totally minimally invasive, hybrid and open Ivor Lewis oesophagectomy in patients with oesophageal cancer. Methods The study was performed using data from the International Esodata Study Group registered between February 2015 and December 2019. The primary outcome was pneumonia, and secondary outcomes included the incidence and severity of anastomotic leakage, (major) complications, duration of hospital stay, escalation of care, and 90-day mortality. Data were analysed using multivariable multilevel models. Results Some 8640 patients were included between 2015 and 2019. Patients undergoing TMIE had a lower incidence of pneumonia than those having hybrid (10.9 versus 16.3 per cent; odds ratio (OR) 0.56, 95 per cent c.i. 0.40 to 0.80) or open (10.9 versus 17.4 per cent; OR 0.60, 0.42 to 0.84) oesophagectomy, and had a shorter hospital stay (median 10 (i.q.r. 8-16) days versus 14 (11-19) days (P = 0.041) and 11 (9-16) days (P = 0.027) respectively). The rate of anastomotic leakage was higher after TMIE than hybrid (15.1 versus 10.7 per cent; OR 1.47, 1.01 to 2.13) or open (15.1 versus 7.3 per cent; OR 1.73, 1.26 to 2.38) procedures. Conclusion Compared with hybrid and open Ivor Lewis oesophagectomy, TMIE resulted in a lower pneumonia rate, a shorter duration of hospital stay, but higher anastomotic leakage rates. Therefore, no clear advantage was seen for either TMIE, hybrid or open Ivor Lewis oesophagectomy when performed in daily clinical practice.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code van der Wilk, Berend J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hagens, Eliza R. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eyck, Ben M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gisbertz, Suzanne S. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Hillegersberg, Richard UNSPECIFIED UNSPECIFIED UNSPECIFIED Nafteux, Philippe UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroder, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Nilsson, Magnus UNSPECIFIED orcid.org/0000-0002-6215-8132 UNSPECIFIED Wijnhoven, Bas P. L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lagarde, Sjoerd M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Henegouwen, Mark I. van Berge UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-689607
DOI:	10.1093/bjs/znab432
Journal or Publication Title:	Br. J. Surg.
Volume:	109
Number:	3
Page Range:	S. 283 - 291
Date:	2022
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1365-2168
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NEOADJUVANT CHEMORADIOTHERAPY; POSTOPERATIVE COMPLICATIONS; CANCER; IMPACT Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68960