Current Oncology Reports

, 16:374

The Contemporary Role of Minimally Invasive Esophagectomy in Esophageal Cancer

Gastrointestinal Cancers (B Czito, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Gastrointestinal Cancers

Abstract

Open surgical resection via transhiatal or transthoracic, including McKeown, access is the most viable option for curing esophageal cancer; however, the extensive nature of open surgery in both the chest and abdomen results in significant rates of morbidity and mortality. A natural response was the introduction of minimally invasive esophagectomy (MIE) and, later, endoscopic resection. In the hands of experienced surgeons, MIE can achieve equivalent or better perioperative mortality, morbidity, and oncologic outcomes as compared to open surgery. This review starts with an overview of open esophagectomy before delving into the evolving body of evidence on MIE outcomes and practices.

Keywords

Esophageal cancer Esophagectomy Ivor-Lewis McKeown Transhiatal Transthoracic Minimally invasive Robotic surgery Outcomes Oncology Cancer Gastrointestinal cancer Minimally invasive esophagectomy (MIE) 

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    NIH – Surveillance Epidemiology and End Results. SEER stat fact sheets: esophagus. (Accessed July 2013). Available at: http://seer.cancer.gov/statfacts/html/esoph.html. Accessed 8/21/13.
  2. 2.
    Enzinger PC, Mayer RJ. Esophageal cancer. N Engl J Med. 2003;349:2241–52.PubMedCrossRefGoogle Scholar
  3. 3.
    Orringer MB, Marshall B, Chang AC, et al. Two thousand transhiatal esophagectomies: changing trends, lessons learned. Ann Surg. 2007;246(3):363–72.PubMedCrossRefGoogle Scholar
  4. 4.
    Casson AG, Fernando HC. Thoracic approaches to esophagectomy. Mastery of cardiothoracic surgery (2nd Ed). Edited by Kaiser LR et al. 2007;c18:1–17 (e-copy).Google Scholar
  5. 5.
    Hulscher JB, van Sandick JW, de Boer AG, et al. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med. 2002;347(21):1662–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Omloo JM, Lagarde SM, Hulscher JB, et al. Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the mid/distal esophagus: five-year survival of a randomized clinical trial. Ann Surg. 2007;246(6):992–1000.PubMedCrossRefGoogle Scholar
  7. 7.
    Boshier PR, Anderson O, Hanna GB. Transthoracic versus transhiatal esophagectomy for the treatment of esophagogastric cancer: a meta-analysis. Ann Surg. 2011;254(6):894–906.PubMedCrossRefGoogle Scholar
  8. 8.
    Rentz J, Bull D, Harpole D, et al. Transthoracic versus transhiatal esophagectomy: a prospective study of 945 patients. J Thorac Cardiovasc Surg. 2003;125(5):1114–20.PubMedCrossRefGoogle Scholar
  9. 9.
    Atkins BZ, Shah AS, Hutcheson KA, et al. Reducing hospital morbidity and mortality following esophagectomy. Ann Thorac Surg. 2004;78:1170–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Lagarde SM, Vrouenraets BC, Stassen LP, van Lanschot JJ. Evidence-based surgical treatment of esophageal cancer: overview of high-quality studies. Ann Thorac Surg. 2010;89(4):1319–26.PubMedCrossRefGoogle Scholar
  11. 11.
    Cuschieri A, Shimi S, Banting S. Endoscopic oesophagectomy through a right thoracoscopic approach. J R Coll Surg Edinb. 1992;37(1):7–11.PubMedGoogle Scholar
  12. 12.
    DePaula AL, Hashiba K, Ferreira EA, et al. Laparoscopic transhiatal esophagectomy with esophagogastroplasty. Surg Laparosc Endosc. 1995;5(1):1–5.PubMedCrossRefGoogle Scholar
  13. 13.•
    Luketich JD, Pennathur A, Awais O, et al. Outcomes after minimally invasive esophagectomy: review of over 1000 patients. Ann Surg. 2012;256(1):95–103. A landmark paper on MIE by the most experienced surgeon in the field.Google Scholar
  14. 14.
    Lazzarino AI, Nagpal K, Bottle A, et al. Open versus minimally invasive esophagectomy: trends of utilization and associated outcomes in England. Ann Surg. 2010;252(2):292–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Gemmill EH, McCulloch P. Systematic review of minimally invasive resection for gastro-oesophageal cancer. Br J Surg. 2007;94(12):1461–7.PubMedCrossRefGoogle Scholar
  16. 16.•
    Decker G, Coosemans W, De Leyn P, et al. Minimally invasive esophagectomy for cancer. Eur J Cardiothorac Surg. 2009;35(1):13–20. A critical review of outcomes from studies prior to 2009. Google Scholar
  17. 17.
    Uttley L, Campbell F, Rhodes M, et al. Minimally invasive oesophagectomy versus open surgery: is there an advantage? Surg Endosc. 2013;27(3):724–31.PubMedCrossRefGoogle Scholar
  18. 18.•
    Nafteux P, Moons J, Coosemans W, et al. Minimally invasive oesophagectomy: a valuable alternative to open oesophagectomy for the treatment of early oesophageal and gastro-oesophageal junction carcinoma. Eur J Cardiothorac Surg. 2011;40(6):1455–63. The most complete singe-institution study of minimally invasive versus open esophagectomy. Google Scholar
  19. 19.
    Ben-David K, Rossidis G, Zlotecki RA, et al. Minimally invasive esophagectomy is safe and effective following neoadjuvant chemoradiation therapy. Ann Surg Oncol. 2011;18(12):3324–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Hanna GB, Arya S, Markar SR. Variation in the standard of minimally invasive esophagectomy for cancer–systematic review. Semin Thorac Cardiovasc Surg. 2012;24(3):176–87.PubMedCrossRefGoogle Scholar
  21. 21.
    Wright CD, Kucharczuk JC, O’Briend SM, et al. Predictors of major morbidity and mortality after esophagectomy for esophageal cancer: a Society of Thoracic Surgeons General Thoracic Surgery Database risk adjustment model. J Thorac Cardiovasc Surg. 2009;137(3):587–96.PubMedCrossRefGoogle Scholar
  22. 22.•
    Biere SS, van Berge Henegouwen MI, Maas KW, et al. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet. 2012;379(9829):1887–92. The first completed RCT on minimally invasive versus open esophagectomy. Google Scholar
  23. 23.
    Luketich JD, Alvelo-Rivera M, Buenaventura PO, et al. Minimally invasive esophagectomy: outcomes in 222 patients. Ann Surg. 2003;238(4):486–94.PubMedGoogle Scholar
  24. 24.
    Parameswaran R, Titcomb DR, Blencowe NS, et al. Assessment and comparison of recovery after open and minimally invasive esophagectomy for cancer: an exploratory study in two centers. Ann Surg Oncol. 2013;20(6):1970–7.PubMedCrossRefGoogle Scholar
  25. 25.
    Scarpa M, Valente S, Alfieri R, et al. Systematic review of health-related quality of life after esophagectomy for esophageal cancer. World J Gastroenterol. 2011;17(42):4660–74.PubMedCrossRefGoogle Scholar
  26. 26.
    Peyre CG, Hagen JA, DeMeester SR, et al. The number of lymph nodes removed predicts survival in esophageal cancer: an international study on the impact of extent of surgical resection. Ann Surg. 2008;248(4):549–56.PubMedGoogle Scholar
  27. 27.
    Rizk NP, Ishwaran H, Rice TW, et al. Optimum lymphadenectomy for esophageal cancer. Ann Surg. 2010;251(1):46–50.PubMedCrossRefGoogle Scholar
  28. 28.
    Veeramachaneni NK, Zoole JB, Decker PA, et al. Lymph node analysis in esophageal resection: American College of Surgeons Oncology Group Z0060 trial. Ann Thorac Surg. 2008;86(2):418–21.PubMedCrossRefGoogle Scholar
  29. 29.
    Pennathur A, Awais O, Luketich JD. Technique of minimally invasive Ivor Lewis esophagectomy. Ann Thorac Surg. 2010;89(6):S2159–62.PubMedCrossRefGoogle Scholar
  30. 30.
    Sarkaria IS, Rizk NP, Finley DJ, et al. Combined thoracoscopic and laparoscopic robotic-assisted minimally invasive esophagectomy using a four-arm platform: experience, technique and cautions during early procedure development. Eur J Cardiothorac Surg. 2013;43(5):e107–15.PubMedCrossRefGoogle Scholar
  31. 31.
    Nagpal K, Ahmed K, Vats A, et al. Is minimally invasive surgery beneficial in the management of esophageal cancer? A meta-analysis. Surg Endosc. 2010;24:1621–9.PubMedCrossRefGoogle Scholar
  32. 32.
    Smithers BM, Gotley DC, Martin I, Thomas JM. Comparison of the outcomes between open and minimally invasive esophagectomy. Ann Surg. 2007;245(2):232–40.PubMedCrossRefGoogle Scholar
  33. 33.
    Markar SR, Arya S, Karthikesalingam A, Hanna GB. Technical factors that affect anastomotic integrity following esophagectomy: systematic review and meta-analysis. Ann Surg Oncol. 2013 Aug 14.Google Scholar
  34. 34.
    Maas KW, Biere SS, Scheepers JJ, et al. Minimally invasive intrathoracic anastomosis after Ivor Lewis esophagectomy for cancer: a review of transoral or transthoracic use of staplers. Surg Endosc. 2012;26(7):1795–802.PubMedCentralPubMedCrossRefGoogle Scholar
  35. 35.
    Dunn DH, Johnson EM, Morphew JA, et al. Robot-assisted transhiatal esophagectomy: a 3-year single-center experience. Dis Esophagus. 2013;26(2):159–66.PubMedCrossRefGoogle Scholar
  36. 36.
    Cerfolio RJ, Bryant AS, Hawn MT. Technical aspects and early results of robotic esophagectomy with chest anastomosis. J Thorac Cardiovasc Surg. 2013;145(1):90–6.PubMedCrossRefGoogle Scholar
  37. 37.
    Weksler B, Sharma P, Moudgill N, et al. Robot-assisted minimally invasive esophagectomy is equivalent to thoracoscopic minimally invasive esophagectomy. Dis Esophagus. 2012;25(5):403–9.PubMedCrossRefGoogle Scholar
  38. 38.
    Palanivelu C, Prakash A, Senthilkumar R, et al. Minimally invasive esophagectomy: thoracoscopic mobilization of the esophagus and mediastinal lymphadenectomy in prone position–experience of 130 patients. J Am Coll Surg. 2006;203(1):7–16.PubMedCrossRefGoogle Scholar
  39. 39.
    Jarral OA, Purkayastha S, Athanasiou T, Zacharakis E. Should thoracoscopic three-stage esophagectomy be performed in the prone or left lateral decubitus position? Interact Cardiovasc Thorac Surg. 2011;13(1):60–5.PubMedCrossRefGoogle Scholar
  40. 40.
    Swisher SG, Deford L, Merriman KW, et al. Effect of operative volume on morbidity, mortality, and hospital use after esophagectomy for cancer. J Thorac Cardiovasc Surg. 2000;119(6):1126–32.PubMedCrossRefGoogle Scholar
  41. 41.
    Enestvedt CK, Perry KA, Kim C, et al. Trends in the management of esophageal carcinoma based on provider volume: treatment practices of 618 esophageal surgeons. Dis Esophagus. 2010;23(2):136–44.PubMedCrossRefGoogle Scholar
  42. 42.
    Birkmeyer JD, Siewers AE, Finlayson EV, et al. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002;346(15):1128–37.PubMedCrossRefGoogle Scholar
  43. 43.
    Markar SR, Karthikesalingam A, Thrumurthy S, Low DE. Volume-outcome relationship in surgery for esophageal malignancy: systematic review and meta-analysis 2000-2011. J Gastrointest Surg. 2012;16(5):1055–63.PubMedCrossRefGoogle Scholar
  44. 44.
    Dimick JB, Goodney PP, Orringer MB, Birkmeyer JD. Specialty training and mortality after esophageal cancer resection. Ann Thorac Surg. 2005;80(1):282–6.PubMedCrossRefGoogle Scholar
  45. 45.•
    Jaffer A. Ajani (chair), et al. Esophageal and esophagogastric junction cancers. NCCN Clinical Practice Guidelines in Oncology v2.2013. (Accessed August 2013). Available: http://www.nccn.org/professionals/physician_gls/pdf/esophageal.pdf. Expert consensus and evidence-based guidelines for the evaluation and treatment of esophageal cancer.
  46. 46.
    Vieth M, Ell C, Gossner L, et al. Histological analysis of endoscopic resection specimens from 326 patients with Barrett’s esophagus and early neoplasia. Endoscopy. 2004;36(9):776–81.PubMedCrossRefGoogle Scholar
  47. 47.
    Pennathur A, Farkas A, Krasinskas AM, et al. Esophagectomy for T1 esophageal cancer: outcomes in 100 patients and implications for endoscopic therapy. Ann Thorac Surg. 2009;87(4):1048–54.PubMedCentralPubMedCrossRefGoogle Scholar
  48. 48.
    Pech O, Behrens A, May A, et al. Long-term results and risk factor analysis for recurrence after curative endoscopic therapy in 349 patients with high-grade intraepithelial neoplasia and mucosal adenocarcinoma in Barrett’s oesophagus. Gut. 2008;57(9):1200–6.PubMedCrossRefGoogle Scholar
  49. 49.
    Hunt BM, Louie BE, Dunst CM, et al. Esophagectomy for failed endoscopic therapy in patients with high-grade dysplasia or intramucosal carcinoma. Dis Esophagus. 2013 Jun 24 (abstract).Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.General SurgeryDuke University Medical CenterDurhamUSA
  2. 2.Cardiothoracic SurgeryDuke University Medical CenterDurhamUSA

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