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Comparison of Short-Term Outcomes Between Open and Minimally Invasive Esophagectomy for Esophageal Cancer Using a Nationwide Database in Japan

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to compare short-term outcomes of minimally invasive esophagectomy (MIE) with those of open esophagectomy (OE) for thoracic esophageal cancer using a nationwide Japanese database.

Methods

Overall, 9584 patients with thoracic esophageal cancer who underwent esophagectomy at 864 hospitals in 2011–2012 were evaluated. We performed one-to-one matching between the MIE and OE groups on the basis of estimated propensity scores for each patient.

Results

After propensity score matching, operative time was significantly longer in the MIE group (n = 3515) than in the OE group (n = 3515) [526 ± 149 vs. 461 ± 156 min, p < 0.001], whereas blood loss was markedly less in the MIE group than in the OE group (442 ± 612l vs. 608 ± 591 ml, p < 0.001). The populations of patients who required more than 48 h of postoperative respiratory ventilation was significantly less in the MIE group than in the OE group (8.9 vs. 10.9%, p = 0.006); however, reoperation rate within 30 days was significantly higher in the MIE group than in the OE group (7.0 vs. 5.3%, p = 0.004). There were no significant differences between the MIE and OE groups in 30-day mortality rates (0.9 vs. 1.1%) and operative mortality rates (2.5 vs. 2.8%, respectively).

Conclusions

MIE was comparable with conventional OE in terms of short-term outcome after esophagectomy. It was particularly beneficial in reducing postoperative respiratory complications, but may be associated with higher reoperation rates.

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Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, Tokyo, Japan

    Hiroya Takeuchi MD, PhD & Yuko Kitagawa MD, PhD

  2. Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan

    Hiroaki Miyata PhD

  3. The Japan Esophageal Society, Tokyo, Japan

    Hiroya Takeuchi MD, PhD, Soji Ozawa MD, PhD, Harushi Udagawa MD, Harushi Osugi MD, PhD, Hisahiro Matsubara MD, PhD & Yuko Kitagawa MD, PhD

  4. The Japanese Society of Gastroenterological Surgery, Tokyo, Japan

    Hiroyuki Konno MD, PhD & Yasuyuki Seto MD, PhD

  5. National Clinical Database, Tokyo, Japan

    Hiroaki Miyata PhD

Authors
  1. Hiroya Takeuchi MD, PhD
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  2. Hiroaki Miyata PhD
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  3. Soji Ozawa MD, PhD
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  4. Harushi Udagawa MD
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  5. Harushi Osugi MD, PhD
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  6. Hisahiro Matsubara MD, PhD
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  7. Hiroyuki Konno MD, PhD
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  8. Yasuyuki Seto MD, PhD
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  9. Yuko Kitagawa MD, PhD
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Corresponding author

Correspondence to Hiroya Takeuchi MD, PhD.

Additional information

This trial is registered as UMIN000016403.

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Takeuchi, H., Miyata, H., Ozawa, S. et al. Comparison of Short-Term Outcomes Between Open and Minimally Invasive Esophagectomy for Esophageal Cancer Using a Nationwide Database in Japan. Ann Surg Oncol 24, 1821–1827 (2017). https://doi.org/10.1245/s10434-017-5808-4

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  • DOI: https://doi.org/10.1245/s10434-017-5808-4

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