Minimally invasive oesophagectomy: Current status and future direction

Butler, Nick, Collins, Stuart, Memon, Breda and Memon, Muhammed Ashraf (2011) Minimally invasive oesophagectomy: Current status and future direction. Surgical Endoscopy, 25 7: 2071-2083. doi:10.1007/s00464-010-1511-2

Author Butler, Nick
Collins, Stuart
Memon, Breda
Memon, Muhammed Ashraf
Title Minimally invasive oesophagectomy: Current status and future direction
Journal name Surgical Endoscopy   Check publisher's open access policy
ISSN 0930-2794
Publication date 2011-07
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1007/s00464-010-1511-2
Open Access Status Not Open Access
Volume 25
Issue 7
Start page 2071
End page 2083
Total pages 13
Place of publication New York, United States
Publisher Springer New York LLC
Language eng
Formatted abstract
Oesophagectomy is one of the most challenging surgeries. Potential for morbidity and mortality is high. Minimally invasive techniques have been introduced in an attempt to reduce postoperative complications and recovery times. Debate continues over whether these techniques are beneficial to morbidity and whether oncological resection is compromised. This review article will analyse the different techniques employed in minimally invasive oesophagectomy (MIO) and critically evaluate commonly reported outcome measures from the available literature.

Medline, Embase, Science Citation Index, Current Contents, and PubMed databases were used to search English language articles published on MIO. Thirty-one articles underwent thorough analysis and the data were tabulated where appropriate. To date, only level III evidence exists. Where appropriate, comparisons are made with a meta-analysis on open oesophagectomy.

Positive aspects of MIO include at least comparable postoperative recovery data and oncological resection measures to open surgery. Intensive care unit requirements are lower, as is duration of inpatient stay. Respiratory morbidity varies. Negative aspects include increased technical skill of the surgeon and increased equipment requirements, increased operative time and limitation with respect to local advancement of cancer. With increasing individual experience, improvements in outcome measures and the amenability of this approach to increasing neoplastic advancement has been shown.

MIO has outcome measures at least as comparable to open oesophagectomy in the setting of benign and nonlocally advanced cancer. Transthoracic oesophagectomy provides superior exposure to the thoracic oesophagus compared to the transhiatal approach and is currently preferred. No multicentre randomised controlled trials exist or are likely to come into fruition. As with all surgery, careful patient selection is required for optimal results from MIO.
Keyword Comparative studies
Intraoperative complications
Oesophageal cancer
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 23 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 38 times in Scopus Article | Citations
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