Minimally Invasive Approach to Esophagectomy May Decrease Morbidity

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."