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Minimally Invasive Procedure Reduces Mortality Compared With Open Surgery in Patients With Oesophageal Cancer: Presented at SSO By Carole Bullock CHICAGO -- March 18, 2008 -- Minimally invasive oesophagectomy (MIE) reduces mortality risk and leads to fewer complications compared with open oesophagectomy (OE) for the treatment of oesophageal cancer, reported researchers here at the Society of Surgical Oncology (SSO) 61st Annual Cancer Symposium. The incidence of oesophageal cancer is on the rise, with 16,000 new cases in the United States in 2008, according to the National Cancer Institute. "However, there is a debate about whether MIE is associated with a higher complication rate, or the degree to which it reduces mortality when compared with open oesophagectomy," said Kenneth Meredith, MD, Surgical Oncology Fellow, H. Lee Moffitt Cancer Center, Tampa, Florida. To performed a statistical comparison of rates of blood loss, lengths of hospitalisation, operative times, need for reoperation, and mortality rates, Dr. Meredith and colleagues conducted a retrospective review of charts from 145 patients with a median age of 66 years who were treated with OE (n = 73) or MIE (n = 72) from 2005 to 2007. Results showed that hospital mortality rates were the same in both groups (2%) and the rate of recurrence was 13.8% in the MIE group versus none in the OE group, Dr. Meredith reported in a poster session on March 14. Operative times were shorter for OE, at 3.9 hours compared with 5 hours for MIE (P = NS). Mean estimated blood loss was 185 mL in OE and 202 mL in MIE (P = NS). Median length of hospitalisation in patients undergoing OE was 10.5 days compared with 10 days in the MIE group (P = NS). Nonpulmonary complication rates were similar in the open and minimally invasive groups (4% vs 8.3%, P = NS). Postoperative atrial fibrillation occurred in 8% of patients but did not differ between groups. Wound complications were higher in the MIE group versus the OE group (P = .017). Overall pulmonary complications were higher in the MIE group (effusions, aspiration, and pneumonia) than in the OE group (P = .0002). The OE group had 1 case of pleural effusion treated with thoracentesis, compared with 13 cases in the MIE group. Pneumonia rates were identical, with a trend toward higher incidence of aspiration in the MIE group (P = .055). Patients who developed any complication exhibited a prolonged length of hospitalisation compared with patients without complications (P = .00006). However, MIE has the "cosmetic advantage due to a smaller incision and patients aren't in the hospital as long," Dr. Meredith said in an interview. [Presentation title: Single Institution Results From Minimally Invasive Oesophagectomy. Poster P111] E-mail this page to a friend or colleague! To print, use this version