SSAT - Is Minimally Invasive Esophagectomy Oncologically Safe? Results of a Case-Control Study

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Is Minimally Invasive Esophagectomy Oncologically Safe? Results of a Case-Control Study
Marisa Aral^*, Hugo Santos-Sousa, José Costa-Maia

General Surgery Department, Centro Hospitalar de São João, University of Porto Medical School, Porto, Portugal

Introduction: Esophagectomy is one of the most challenging surgical procedures. Minimally invasive techniques (MIE) have been introduced in an attempt to reduce postoperative complications and recovery times. Debate continues over whether the quality of the oncological resection is compromised. The aim of this study was the comparative analysis of the oncologic results between MIE and open esophagectomy (OE).
Methods: We performed a case-control study based in a prospective database with esophageal cancer cases submitted to curative intent surgery, between May 2006 and October 2014.
Results: The 65 cases included in this study were divided in two groups (24 MIE vs 41 OE), which were matched for gender, age, comorbidities, BMI, tumor location and histology, staging, neoadjuvant therapy and type of surgery. The postoperative in-hospital mortality was 0 in MIE and 22% in OE. Statistically significant differences were observed in the mean of lymph nodes (LN) retrieved (18,5±8,9 vs 15,3±10,6, p=0,049), but there weren't significant differences in R0 resection rate (95,8% vs 89,5%). The median follow-up was 9 [0-97] months. For the survival and recurrence analysis the cases of in-hospital mortality were excluded. Recurrence occurred in 37,5% vs 56,3% (p=ns), respectively. In disease-specific and disease-free survival curves there weren't significant differences between the 2 groups.
Conclusions: The results of this case-control study provide further evidence for the oncological safety of MIE, with comparable results to OE.

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