Abstract

EFFECTIVENESS OF MINIMALLY INVASIVE OESOPHAGECTOMY IN REDUCING MORBIDITY FOR CANCER OESOPHAGUS

Author(s): Thangasamy Selvaraj

BACKGROUND Surgery remains the gold standard treatment modality for oesophageal carcinoma especially for middle third and lower third segments of oesophagus. Open trans-hiatal or transthoracic oesophagectomy is associated with increased morbidity, increased blood loss, more stay in ICU due to pain and prolonged hospital admission. To minimise morbidity, various types of minimally invasive oesophagectomies are being tried, in very few centres, having high volume, with experienced oesophageal surgeons. MATERIALS AND METHODS The aim of the study was to compare the outcomes of Thoracoscopic and laparoscopic (TLE) removal of oesophagus for resectable cancer of oesophagus with open trans hiatal (OPEN) oesophagectomy for a three years period from January 2015 to December 2017. RESULTS There were 20 patients who underwent open transhiatal oesophagectomy and thoracoscopic laparoscopic oesophagectomy was performed in 10 patients. Out of 30 patients, 18 patients (60%) are males and 12 (40%) patients are females. All TLE patients had significantly less blood loss (p value <0.0000001), 1-day ICU stay (p value <0.0000001) and pain score (p value <0.0000001) compared to open oesophagectomy. CONCLUSION Thoracoscopic & Laparoscopic Oesophagectomy is a feasible technique and has equivalent or better oncologic clearance compared to open technique. Stage by stage comparison of TLE shows significantly minimal blood loss and less ICU stay but it needs to have large volume patients in a prospective randomized trial for further validation.