Original articleGeneral thoracicMinimally Invasive Versus Open Esophagectomy for Esophageal Cancer: A Comparison of Early Surgical Outcomes From The Society of Thoracic Surgeons National Database
Section snippets
Material and Methods
The STS General Thoracic Database (v. 2.081) was queried for all patients who underwent OE and MIE from 2008 to 2011 for esophageal cancer. These corresponded to International Classification of Disease (ICD) 9/10 diagnostic codes 150.4, 150.5, and 151.0 and procedure codes 43107, 43117, 43112, 43117, 43122, and 43XXX on the STS General Thoracic Database Data Collection Form. The comparison included the total case groups of MIE and OE, and a subgroup analysis of Ivor Lewis and transhiatal
Results
Query of the STS General Thoracic Database resulted in a total of 3,780 esophagectomies that were performed for cancer of the middle and lower esophagus between 2008 and 2011, of which 2,966 were OE and 814 were MIE. Total populations of MIE and OE, as well as subgroups, were analyzed. Excluding alternative approaches, subgroup analysis was performed such that minimally invasive approaches included both transhiatal (n = 214) and Ivor Lewis (n = 600), and these were compared directly with open
Comment
This study is one of the first to report the results of a large, multiinstitutional, national database comparison of MIE versus OE for esophageal cancer in the United States. These data suggest that MIE, in particular minimally invasive Ivor Lewis and transhiatal esophagectomy, is safe and equivalent to OE technique with respect to overall morbidity and mortality. Operative mortality was found to be low at 3.3% for MIE patients and 3.9% for OE patients. We believe this result is remarkable for
References (24)
- et al.
The role of surgery in the management of oesophageal cancer
Lancet Oncol
(2003) - et al.
Comparison of perioperative outcomes after combined thoracoscopic-laparoscopic esophagectomy and open Ivor-Lewis esophagectomy
Am J Surg
(2010) - et al.
Short-term outcomes of minimally invasive Ivor-Lewis esophagectomy for esophageal cancer
Ann Thorac Surg
(2014) - et al.
Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial
Lancet
(2012) - et al.
Lobectomy by video-assisted thoracic surgery (VATS) versus thoracotomy for lung cancer
J Thorac Cardiovasc Surg
(2009) - et al.
Thoracoscopic lobectomy is associated with lower morbidity than open lobectomy: a propensity-matched analysis from the STS database
J Thorac Cardiovasc Surg
(2010) - et al.
Minimally invasive Ivor Lewis esophagectomy: description of a learning curve
J Am Coll Surg
(2014) - et al.
External validation of the Society of Thoracic Surgeons General Thoracic Surgery Database
Ann Thorac Surg
(2013) - National Cancer Institute, Surveillance, Epidemiology, and End Results Program. SEER Stat Fact Sheets: Esophageal...
- et al.
Hospital volume and surgical mortality in the United States
N Engl J Med
(2002)