Short-term outcomes after minimally invasive oesophagectomy.

Ainsworth, Alan Patrick; Larsen, Michael Hareskov; Ladegaard, Lars; Eckardt, Jens; Fristrup, Claus Wilki; Mortensen, Michael Bau

INTRODUCTION Minimally invasive oesophagectomy (MIO) has gained increasing popularity. This study reports the results of the first patients operated using this technique at our department. METHODS All procedures were prospectively registered in a database. Patients were followed until death, two years after surgery or 1 January 2019. RESULTS A total of 150 procedures were performed (from 23 November 2015 to 27 February 2018). The median proced-ure time decreased from 350 minutes for the initial 75 pa-tients to 320 minutes for the final 75 patients (p < 0.05). Blood loss decreased from 200 ml to 100 ml (p < 0.05), respectively. The conversion rate for the abdominal procedure was 7% for the initial 75 patients and 8% for the final 75 patients (not significant (NS)). For the thoracic procedure, the corresponding figures were 11% and 7% (NS), respectively. Anastomotic leakage was seen in 17% (initial patients) and 11% (final patients) (NS); however, less than 20% of the leakages needed surgical treatment. The median length of post-operative stay was nine days for both groups. For all 150 patients, pulmonary complications were observed in 18% and cardiac complications in 11%. The 30-day mortality rate was 2% and the one-year survival rate was 86% (124 registered patients). CONCLUSIONS MIO was introduced at our department with acceptable morbidity and mortality rates and the short-term oncological result was not compromised. FUNDING none. TRIAL REGISTRATION The study was approved as a quality project by the Region of Southern Denmark (18/37355).