Universität zu Köln

Berlth, Felix, Plum, Patrick S. ORCID: 0000-0002-8165-4553, Chon, Seung-Hun ORCID: 0000-0002-8923-6428, Gutschow, Christian A., Bollschweiler, Elfriede and Hoelscher, Arnulf H. (2018). Total minimally invasive esophagectomy for esophageal adenocarcinoma reduces postoperative pain and pneumonia compared to hybrid esophagectomy. Surg. Endosc., 32 (12). S. 4957 - 4966. NEW YORK: SPRINGER. ISSN 1432-2218

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Abstract

BackgroundThe impact of total minimally invasive esophagectomy (MIE) on early postoperative outcome and patient's survival is a matter of recent discussion.MethodsWe performed a 1:2 propensity score-matched comparison of 20 patients who underwent 3D-MIE and high intrathoracic esophagogastrostomy with 40 patients who underwent hybrid esophagectomy (HYBRID) with laparoscopic gastric mobilization and open transthoracic esophagectomy and the same anastomosis for esophageal adenocarcinoma in 2014 and 2015. Matching criteria were tumor localization, age, gender, and neoadjuvant treatment.ResultsBoth groups did not differ regarding overall postoperative complications (MIE 55% vs. HYBRID 50%, p=0.715) and anastomotic leakage (MIE 15% vs. HYBRID 5%, p=0.186). A significant difference was seen regarding the rate of postoperative pneumonia (MIE 5% vs. HYBRID 27.5%; p=0.040) and the postoperative ICU stay (MIE median 1day vs. HYBRID median 2 days, p<0.001). The R0-resection rate was 100% in both groups and median number of dissected lymph nodes was 32 for MIE and 35 for HYBRID (p=0.236). Significant differences between both groups were noticed for postoperative number of patients with use of opiate demand medication and numeric rating scale for pain (NRSP maximum pain, median) both in favor of the MIE group (MIE 25%, NRSP 2 vs. HYBRID 60%, NRSP 4; p=0.011, p<0.001). Overall 2-year survival rate was 85% in both groups.ConclusionTotal minimally invasive esophagectomy is superior to hybrid esophagectomy in regard of postoperative pain and rate of pneumonia. No differences exist for postoperative surgical complications or short-term prognosis.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Berlth, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Plum, Patrick S. UNSPECIFIED orcid.org/0000-0002-8165-4553 UNSPECIFIED Chon, Seung-Hun UNSPECIFIED orcid.org/0000-0002-8923-6428 UNSPECIFIED Gutschow, Christian A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bollschweiler, Elfriede UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf H. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-164676
DOI:	10.1007/s00464-018-6257-2
Journal or Publication Title:	Surg. Endosc.
Volume:	32
Number:	12
Page Range:	S. 4957 - 4966
Date:	2018
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-2218
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TRANSTHORACIC ESOPHAGECTOMY; EPIDURAL ANALGESIA; MULTICENTER; OUTCOMES Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16467