Minimally Invasive Esophagectomy for Achieving R0.
Background
Minimally invasive esophagectomy (MIE) is becoming increasing popular. Since it was introduced, there has been debate about its safety and efficacy when compared with open esophagectomies (OE). We sought to compare the oncologic outcomes of MIE and OE in this study specifically with regards to margin status and nodal retrieval.


Methods
Ninety-three patients that underwent MIE (76/93) or OE (17/93) for esophageal cancer at out institution between January 2013 and September 2018 were retrospectively reviewed. Histological type, pathological tumor grading, clinical tumor staging (cTNM), pathological tumor staging (pTNM), post-neoadjuvant tumor staging (ypTNM), and lymph node retrieval were obtained and compared.


Results
The results show a statistically significant improvement in resection margins (R0) in the MIE group when compared with the OE group. Other oncologic parameters including clinical staging, pathologic staging, tumor grade, neoadjuvant therapy (NAT), and nodal retrieval were not statistically significantly different between the open and MIE groups.


Conclusion
The improvement in short-term surgical outcomes in MIE is well established. This study demonstrates that MIE can have superior surgical oncologic outcomes compared to OE, this was specifically an improved R0 margin rate with MIE compared to OE. These results further support the use of MIE in the treatment of esophageal cancer.
['Darwish|Muhammad B|MB|', 'Nagatomo|Kei|K|', 'Jackson|Terence|T|', 'Cho|Edward|E|', 'Osman|Houssam|H|', 'Jeyarajah|D Rohan|DR|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D004938:Esophageal Neoplasms D016629:Esophagectomy D005260:Female D006801:Humans D008198:Lymph Nodes D008297:Male D000072662:Margins of Excision D008875:Middle Aged D019060:Minimally Invasive Surgical Procedures D009367:Neoplasm Staging D012189:Retrospective Studies D016896:Treatment Outcome
Minimally Invasive Esophagectomy Open Esophagectomy Oncologic Outcome Esophageal Cancer Robotic-assisted Esophagectomy