Comparison the Outcomes of Open Thoracotomy and Minimally Invasive Thoracoscopic Esophagectomy in Esophageal Cancer

Introduction: Surgery is the first therapeutic option for esophageal cancer. There is controversy over the selection of the best surgical approach. Regarding this, the present study aimed to compare the minimally invasive and open esophagectomy in terms of their short-term outcomes and preoperative complications. Materials & Methods: This randomized clinical trial was conducted on 61 patients in Ghaem Hospital, Mashhad, Iran, within 2011-2013. The patients were assigned into two groups based on the type of therapeutic approach they received. The minimally invasive esophagectomy (MIE) and open esophagectomy (OE) groups consisted of 31 and 30 patients, respectively. For the purpose of the study, we collected such data as age, gender, site of lesion, bleeding, duration of surgery, rate of switch to open approach, post-operative morbidity, duration of hospital stay, and mortality rate. Results: According to the results of the study, 60.7% of the participants were male. The mean age of the patients was 62.39±11.91 years. There was no significant difference between the two groups regarding the site of lesion (P=0.014) and stage of tumor (P=0.108). No significant difference was observed between the MIE and OE groups in terms of the blood transfusion (P=0.981). Considering the complications, there was one case of fistula in the MIE group; furthermore, one and two cases of wound infection and pleural effusions were observed in the OE group, respectively. There were no significant differences between the two groups in terms of the post-operative complications, namely fistula, pleural effusions, and wound infection (P=0.492, P=0.238, and P=0.492, respectively). The MIE group had longer operation time (P≤0.001). There was one patient in the MIE group converted to open approach. The duration of hospitalization was significantly longer in the OE group, and there was no mortality. Conclusion: As the findings of the present study demonstrated, the MIE outcomes were comparable with those of the OE with improved short-term outcomes.

Keywords:

Esophageal Cancer , Minimally invasive surgery , thoracoscopic esophagectomy