Minimally Invasive Ivor-Lewis Oesophagectomy Is A Feasible And Safe Approach For Patients With Oesophageal Cancer

Background: Minimally invasive approaches are increasingly being used in oesophagectomy. The aim of this study was to compare the short-term clinical outcomes of the minimally invasive Ivor-Lewis oesophagectomy (MIILE) technique with those of the open Ivor-Lewis oesophagectomy (OILE) technique.Methods: We identified 131 patients who underwent MIILE combined with thoracoscopy and laparoscopy. These patients were compared with 248 patients who underwent OILE between January 2012 and December 2013.Results: MIILE and OILE produced similar post-operative hospital mortality (MIILE 2.3 versus OILE 2%; P = 1.000). The MIILE approach was associated with a significant decrease in the time until chest drain removal (MIILE 9.07 +/- 5.075 days versus OILE 11.26 +/- 6.989 days; P = 0.002) and post-operative length of stay (MIILE 10.89 +/- 4.976 days versus OILE 12.83 +/- 6.921 days; P = 0.002). Pneumonia was the most common complication in both groups. MIILE patients exhibited a lower incidence of post-operative pneumonia (MIILE 17.6% versus OILE 28.2%; P = 0.024) compared with OILE. The survival rate did not significantly differ between the MIILE and OILE groups (1-year survival rates: MIILE 86 versus OILE 88.2%; P = 0.537).Conclusions: In this study, we demonstrate that MIILE is a feasible and safe approach for patients with middle or lower oesophageal cancer.