Portal de Periódicos da CAPES

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

2021; Oxford University Press; Volume: 109; Issue: 3 Linguagem: Inglês

10.1093/bjs/znab432

1365-2168

Berend J. van der Wilk, Eliza Hagens, Ben M. Eyck, Suzanne S. Gisbertz, Richard van Hillegersberg, Philippe Nafteux, Wölfgang Schröder, Magnus Nilsson, Bas P. L. Wijnhoven, Sjoerd M. Lagarde, Mark I. van Berge Henegouwen, J. Jan B. van Lanschot, Egle Jezerskyte, Wietse J. Eshuis, Jelle P. Ruurda, Sylvia van der Horst, Arjen van der Veen, Gino M. Kuiper, Antoon Lerut, Johnny Moons, Marc Bludau, Christiane J. Bruns, Fredrik Klevebro, Masaru Hayami, Xavier Benoît D’Journo, Delphine Trousse, Geoffrey Brioude, Richard Hardwick, Peter Safranek, John M. Bennett, Andrew Hindmarsh, Vijay Sujendran, J. Robert O’Neill, Arnulf H. Hoelscher, Martin Hemmerich, Guillaume Piessen, Marguerite Messier, Sébastien Degisors, Frederiek Nuytens, Blair A. Jobe, Ali H. Zaidi, Andrew Davies, Janine Zylstra, James Gossage, Cara Baker, Mark Kelly, Paul M. Schneider, Simone Schillinger, Manuel Pera, Marta Gimeno, Yuko Kitagawa, Hirofumi Kawakubo, Satoru Matsuda, Yuki Hirata, Christopher R. Morse, Julie M. Garrity, Wayne L. Hofstetter, Huawei Tang, Daniela Molena, Manjit S. Bains, Joseph Dycoco, Kristen Busalacchi, Rebecca Carr, David R. Jones, Jimmy Bok Yan So, Asim Shabbir, Arul Immanuel, Michael J. Griffin, Helen Jaretzke, Simon L. Parsons, Neil T. Welch, Ravinder Vohra, James Catton, J. Saunders, Fady Yanni, Daniela Zanotti, Pritam Singh, M. Larsen, Larsen Nicolaj, Marcus Stilling, James P. Dolan, Stephanie G. Wood, Charlie Borzy, Kayla Siemens, Nick Maynard, John M. Findlay, Stephen Ash, B. Mark Smithers, Iain Thomson, Andrew P. Barbour, Janine Thomas, Susana Puig, John Whiting, Simon Law, Yhi Wong, Jeannette Kwok, Andrew Kennedy, Raymond Kennedy, Ning Wang, Qiang Fang, Yongtao Han, Peng Lin, Wenguang Xiao, John V. Reynolds, Sinéad King, Narayanasamy Ravi, C.S. Pramesh, Apurva Ashok, Mark K. Ferguson, Amy Durkin-Celauro, Catherine Staub, Gail Darling, Emma Small, Timothy J. Underwood, James Byrne, Jamie Kelly, Fergus Noble, Donna Sharland, Rachel Fraser, Robert A. Walker, Saqib Rahman, Ben Grace, Andrew C. Chang, Judy Miller, Shari Barnett, Ivan Cecconello, Ulysses Ribeiro, Rubens Antônio Aissar Sallum, Giovanni de Manzoni, Jacopo Weindelmayer, Carlo Alberto De Pasqual, Riccardo Rosati, Paolo Parise, Andrea Cossu, Francesco Puccetti, Simonetta Massaron, Madhan Kumar Kuppusamy, Bonnie Marston, Donald E. Low,

Esophageal and GI Pathology

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.