fbpx

Minimally Invasive Surgery for Esophageal Cancer-A meta-analysis

Share Button

There was no significant difference in 30-day mortality among esophageal cancer patients; however, MIE had lower blood loss, shorter hospital stay, and reduced total morbidity and respiratory complications.

Esophageal cancer is the eighth most common cancer in the world today and depending on stage at diagnosis, the five year survival rate is between 13% and 18% according to research. Esophagectomy is a major surgical procedure associated with a significant risk of morbidity and mortality. Minimally invasive esophagectomy is becoming the preferred approach because of the potential to limit surgical trauma, reduce respiratory complications, and promote earlier functional recovery.

Because esophagectomy is the standard-of-care, I researched studies comparing open surgery to minimally invasive esophagectomy. According to studies, there isn’t much difference in the outcomes of MIE and open surgery.

However my experience as a cancer survivor (of a different cancer) and cancer coach is that cancer surgery depends on two main criteria:

  • The surgeon and
  • The patient-

When I read the above I think that is both obvious and sort of silly for me to say that. But let me explain. When I say the surgeon makes a real difference, I am referring to the experience of the surgeon. I encourage esoph. patients to meet with the surgeon to ask him or her about how many, what outcomes, etc.

When I say that the cancer patient makes a real difference what I mean is the age, physical condition, prehabilitation, etc. before he/she undergoes surgery.

Studies comparing open with MIE can’t account for the surgeon’s experience nor the patient’s preparation.

I am both a cancer survivor and cancer coach. I work with cancer patients to research and identify those centers and/or those surgeons who are at the top of their profession and may have better outcomes. I have reserched those evidence-based therapies that esophageal cancer need to improve their outcomes.

Have you been diagnosed with esophageal cancer? If so, what stage? What therapies are you considering? Scroll down the page, post a question or comment and I will reply to you ASAP.

Click now to go to the Complete Cancer Coaching Products page. 

Thank you,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Is minimally invasive surgery beneficial in the management of esophageal cancer? A meta-analysis

Introduction

Open esophagectomy for cancer is a major oncological procedure, associated with significant morbidity and mortality. Recently, thoracoscopic procedures have offered a potentially advantageous alternative because of less operative trauma compared with thoracotomy. The aim of this study was to utilize meta-analysis to compare outcomes of open esophagectomy with those of minimally invasive esophagectomy (MIE) and hybrid minimally invasive esophagectomy (HMIE).

Methods  
Literature search was performed using Medline, Embase, Cochrane Library, and Google Scholar databases for comparative studies assessing different techniques of esophagectomy. A random-effects model was used for meta-analysis, and heterogeneity was assessed. Primary outcomes of interest were 30-day mortality and anastomotic leak. Secondary outcomes included operative outcomes, other postoperative outcomes, and oncological outcomes in terms of lymph nodes retrieved.
Results  
A total of 12 studies were included in the analysis. Studies included a total of 672 patients for MIE and HMIE, and 612 for open esophagectomy. There was no significant difference in 30-day mortality; however, MIE had lower blood loss, shorter hospital stay, and reduced total morbidity and respiratory complications. For all other outcomes, there was no significant difference between the two groups.

Less-invasive option effective in early esophageal cancer

“Use of a minimally invasive endoscopic procedure to remove superficial, early-stage esophageal cancer is as effective as surgery that removes and rebuilds the esophagus, according to a new study. The study examined national outcomes from endoscopic treatment and from esophagectomy, which is surgical removal of the esophagus…

Endoscopic therapy was found to offer long-term survival rates similar to those for esophagectomy,  “Endoscopic resection in the esophagus is similar to how we remove polyps in the colon, although it is much more technically complex. Esophagectomy is a major surgical procedure that cuts out the entire esophagus, and pulls the stomach into the neck to create a new food tube.”

Leave a Comment: