Minimally invasive surgery for oesophageal cancer

• Published in: Baillière's best practice & research. Clinical gastroenterology Vol. 28; no. 1; pp. 41 - 52
• Main Authors: Anderegg, Maarten C.J., Gisbertz, Suzanne S., van Berge Henegouwen, Mark I.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2014; Elsevier Limited
• Subjects: Dissection; Esophageal Neoplasms - mortality; Esophageal Neoplasms - pathology; Esophageal Neoplasms - surgery; Esophagectomy - adverse effects; Esophagectomy - methods; Esophagectomy - mortality; Esophagectomy - standards; Gastroenterology and Hepatology; Humans; Intensive care; Laparoscopy; Laparoscopy - adverse effects; Laparoscopy - mortality; Laparoscopy - standards; Minimally invasive surgery; Minimally Invasive Surgical Procedures; Mortality; Neoplasm Recurrence, Local - etiology; Oesophageal cancer; Oesophagectomy; Ostomy; Patient Selection; Patients; Risk Factors; Robotics; Standard of Care; Surgery; Surgery, Computer-Assisted; Thoracic Surgical Procedures - adverse effects; Thoracic Surgical Procedures - mortality; Thoracic Surgical Procedures - standards; Thoracoscopy; Treatment Outcome; Tumors; Veins & arteries; Oesophageal cancer; Minimally invasive surgery; Laparoscopy; Oesophagectomy; Thoracoscopy
• ISSN: 1521-6918; 1532-1916; 1532-1916
• DOI: 10.1016/j.bpg.2013.11.002

Worldwide an increasing part of oncologic oesophagectomies is performed in a minimally invasive way. Over the past decades multiple reports have addressed the perioperative outcomes and oncologic safety of minimally invasive oesophageal surgery. Although many of these (retrospective) case–control studies identified minimally invasive oesophagectomy as a safe alternative to open techniques, the clear benefit remained subject to debate. Recently, this controversy has partially resolved due to the results of the first randomized controlled trial that compared both techniques. In this trial short-term benefits of minimally invasive oesophagectomy were demonstrated in terms of lower incidence of pulmonary infections, shorter hospital stay and better postoperative quality of life. However, the current lack of long-term data on recurrence rate and overall survival precludes a comprehensive comparison of minimally invasive and open oesophagectomy. Proclaiming minimally invasive oesophagectomy as the standard of care for patients with resectable oesophageal cancer would therefore be a premature decision.