Minimally invasive surgery for esophagectomy may
lower the morbidity often associated with open
esophagectomy, according to a study conducted by surgeons at the University of
Pittsburgh Medical Center and published in the September 2000 issue of the
Annals of Thoracic Surgery. The study, which was conducted from August 1996 to
September 1999, examined the outcomes of 77 patients who underwent minimally
invasive procedures for esophagectomy. Of those 77, 50 were men and 27 were
women, with an average age of 66 years. The average hospital stay was about 7
days, with no operative or hospital mortalities.
Technically Feasible and Safe
"The results of this study show that minimally invasive
esophagectomy is technically feasible and safe in a center where surgeons have
extensive experience in both minimally invasive and open esophagectomy,"
said James Luketich, MD, principal investigator of the study, assistant
professor of surgery, and section head of thoracic surgery at the University of
Pittsburgh Medical Center.
Esophagectomy remains the standard of care for localized
esophageal cancer. Surgical options include thoracotomy, laparotomy, or both.
These procedures, however, can be associated with significant morbidity and
mortality and a delay in the patient’s return to routine activities.
"Open surgery should remain the standard until future
studies conclusively demonstrate advantages of minimally invasive
approaches," stressed Dr. Luketich, who also serves as codirector of the
University of Pittsburgh Cancer Institute’s Lung Cancer Center and the Mark
Ravitch/Leon C. Hirsch Center for Minimally Invasive Surgery. "However,
advances in minimally invasive instrumentation, increasing applications of less
invasive techniques to a variety of disorders, and the potential for less
morbidity are encouraging surgeons to explore the role of less invasive
techniques for this type of procedure."