Comparison of minimally invasive esophagectomy with transthoracic and transhiatal esophagectomy

Hypothesis: Minimally invasive esophagectomy can be performed as safely as conventional esophagectomy and has distinct perioperative outcome advantage s. Design: A retrospective comparison of 3 methods of esophagectomy: minimally invasive, transthoracic, and blunt transhiatal. Setting: University medical center. Patients: Eighteen consecutive patients underwent combined thoracoscopic an d laparoscopic esophagectomy from October 9, 1998, through January 19, 2000 . These patients were compared with 16 patients who underwent transthoracic esophagectomy and 20 patients who underwent blunt transhiatal esophagectom y from June 1, 1393, through August 5, 1998. Main Outcome Measures: Operative time, amount of blood loss, number of oper ative transfusions, length of intensive care and hospital stays, complicati ons, and mortality. Results: Patients who had minimally invasive esophagectomy had shorter oper ative times, less blood loss, fewer transfusions, and shortened intensive c are unit and hospital courses than patients who underwent transthoracic or blunt transhiatal esophagectomy. There was no significant difference in the incidence of anastomotic leak or respiratory complications among the 3 gro ups. Conclusion: Minimally invasive esophagectomy is safe and provides clinical advantages compared with transthoracic and blunt transhiatal esophagectomy.