Article ; Online: Experiences in reverse sequence esophagectomy: a promising alternative for esophageal cancer surgery.
2023 Volume 37, Issue 9, Page(s) 6749–6760
Abstract: Objectives: McKeown esophagectomy is a standard and significant component of multimodality therapy in esophageal cancer, however, experience in switching the resection and reconstruction sequence in esophageal cancer surgery is not available. Here, we ... ...
Abstract | Objectives: McKeown esophagectomy is a standard and significant component of multimodality therapy in esophageal cancer, however, experience in switching the resection and reconstruction sequence in esophageal cancer surgery is not available. Here, we have retrospectively reviewed the experience of reverse sequencing procedure at our institute. Methods: We retrospectively reviewed 192 patients who had undergone minimally invasive esophagectomy (MIE) with McKeown esophagectomy between August 2008 and Dec 2015. The patient's demographics and relevant variables were evaluated. The overall survival (OS) and disease-free survival (DFS) were analyzed. Results: Among the 192 patients, 119 (61.98%) received the reverse sequence MIE (the reverse group) and 73 patients (38.02%) received the standard operation (the standard group). Both patient groups had similar demographics. There were no inter-group differences existed in blood loss, hospital stay, conversion rate, resection margin status, operative complication, and mortality. The reverse group had shorter total operation time (469.83 ± 75.03 vs 523.63 ± 71.93, p < 0.001) and thoracic operation time (181.22 ± 42.79 vs 230.41 ± 51.93, p < 0.001). The 5-year OS and DFS for both groups were similar (44.77% and 40.53% in the reverse group vs 32.66% and 29.42% in the standard group, p = 0.252 and 0.261, respectively). Similar results were observed even after propensity matching. Conclusions: The reverse sequence procedure had shorter operation times, especially in the thoracic phase. The reverse sequence MIE is a safe and useful procedure when postoperative morbidity, mortality, and oncological outcomes are considered. |
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MeSH term(s) | Humans ; Treatment Outcome ; Esophagectomy/methods ; Retrospective Studies ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Esophageal Neoplasms ; Minimally Invasive Surgical Procedures/methods |
Language | English |
Publishing date | 2023-05-22 |
Publishing country | Germany |
Document type | Journal Article |
ZDB-ID | 639039-0 |
ISSN | 1432-2218 ; 0930-2794 |
ISSN (online) | 1432-2218 |
ISSN | 0930-2794 |
DOI | 10.1007/s00464-023-10120-y |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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