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van der Wilk BJ, Hagens ERC, Eyck BM, et al. Outcomes after totally minimally invasive versus hybrid and open Ivor Lewis oesophagectomy: results from the International Esodata Study Group. Br J Surg. 2022;doi: 10.1093/bjs/znab432.
van der Wilk, B. J., Hagens, E. R. C., Eyck, B. M., Gisbertz, S. S., van Hillegersberg, R., Nafteux, P., Schröder, W., Nilsson, M., Wijnhoven, B. P. L., Lagarde, S. M., van Berge Henegouwen, M. I. (2022). Outcomes after totally minimally invasive versus hybrid and open Ivor Lewis oesophagectomy: results from the International Esodata Study Group. The British journal of surgery, . https://doi.org/10.1093/bjs/znab432
van der Wilk, Berend J, et al. "Outcomes after totally minimally invasive versus hybrid and open Ivor Lewis oesophagectomy: results from the International Esodata Study Group." The British journal of surgery vol. (2022). doi: https://doi.org/10.1093/bjs/znab432
van der Wilk BJ, Hagens ERC, Eyck BM, Gisbertz SS, van Hillegersberg R, Nafteux P, Schröder W, Nilsson M, Wijnhoven BPL, Lagarde SM, van Berge Henegouwen MI. Outcomes after totally minimally invasive versus hybrid and open Ivor Lewis oesophagectomy: results from the International Esodata Study Group. Br J Surg. 2022 Jan 13; doi: 10.1093/bjs/znab432. Epub 2022 Jan 13. PMID: 35024794.
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Br J Surg. 2022 Jan 13; doi: 10.1093/bjs/znab432. Epub 2022 Jan 13.

Outcomes after totally minimally invasive versus hybrid and open Ivor Lewis oesophagectomy: results from the International Esodata Study Group.

The British journal of surgery

Berend J van der Wilk, Eliza R C Hagens, Ben M Eyck, Suzanne S Gisbertz, Richard van Hillegersberg, Philippe Nafteux, Wolfgang Schröder, Magnus Nilsson, Bas P L Wijnhoven, Sjoerd M Lagarde, Mark I van Berge Henegouwen,

Affiliations

  1. Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
  2. Department of Surgery, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam Cancer Centre, Amsterdam, the Netherlands.
  3. Department of Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands.
  4. Department of Thoracic Surgery, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium.
  5. Department of General, Visceral, Cancer and Transplantation Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
  6. Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
  7. Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden.

PMID: 35024794 DOI: 10.1093/bjs/znab432

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.

© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.

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