Minimally Invasive Approach to Esophagectomy May Decrease Morbidity

Minimally invasive surgery for esophagectomy maylower the morbidity often associated with openesophagectomy, according to a study conducted by surgeons at the University ofPittsburgh Medical Center and published in the September 2000 issue of the Annals of Thoracic Surgery. The study, which was conducted from August 1996 toSeptember 1999, examined the outcomes of 77 patients who underwent minimallyinvasive procedures for esophagectomy. Of those 77, 50 were men and 27 werewomen, with an average age of 66 years. The average hospital stay was about 7days, with no operative or hospital mortalities.

Technically Feasible and Safe

"The results of this study show that minimally invasiveesophagectomy is technically feasible and safe in a center where surgeons haveextensive experience in both minimally invasive and open esophagectomy,"said James Luketich, MD, principal investigator of the study, assistantprofessor of surgery, and section head of thoracic surgery at the University ofPittsburgh Medical Center.

Esophagectomy remains the standard of care for localizedesophageal cancer. Surgical options include thoracotomy, laparotomy, or both.These procedures, however, can be associated with significant morbidity andmortality and a delay in the patient’s return to routine activities.

"Open surgery should remain the standard until futurestudies conclusively demonstrate advantages of minimally invasiveapproaches," stressed Dr. Luketich, who also serves as codirector of theUniversity of Pittsburgh Cancer Institute’s Lung Cancer Center and the MarkRavitch/Leon C. Hirsch Center for Minimally Invasive Surgery. "However,advances in minimally invasive instrumentation, increasing applications of lessinvasive techniques to a variety of disorders, and the potential for lessmorbidity are encouraging surgeons to explore the role of less invasivetechniques for this type of procedure."