Khirurgiia · 2025
[Short-term outcomes of the McKeown esophagectomy for thoracic esophageal cancer: a multiple-center study].
СтатьяМногоцентровое исследованиеАннотация на английскомНазвание и аннотация: Перевод в очереди
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Ryabov A B, Pikin O V, Khomyakov V M, Kolobaev I V, Toneev E A, Abdulkhakimov N M, Gamayunov S V, Kiselev N M, Alexandrov O A, Sobolev D D, Afonin G V, Smolenov E I, Torgomyan G G, Martynov A A
Аннотация
OBJECTIVE: To analyze short-term outcomes of the McKeown esophagectomy in 4 cancer centers of the Russian Federation.
MATERIAL AND METHODS: The study included 175 patients who underwent open, hybrid or minimally invasive McKeown esophagectomy between 2016 and 2023 in 4 cancer centers of the Russian Federation. Traditional open esophagectomy was performed in 69 (39.4%) patients, hybrid - in 78 (44.6%), minimally invasive - in 28 (16%) patients.
RESULTS: Median time of minimally invasive surgery was 395 min [358.25; 436.25], hybrid procedure - 357.5 min [300.00; 403.75], open esophagectomy - 315 min [265.00; 390.00] (p<0.001). Mean blood loss was 175, 150 and 300 ml, respectively (p<0.001). Conversion rate for hybrid interventions was 2.5%, for minimally invasive esophagectomy - 3.5%. Mean number of resected lymph nodes was higher in minimally invasive groups (open - 19.7±7.5; hybrid - 21.3±13.1; minimally invasive esophagectomy - 21.7±12.4 p=0.007). Major postoperative complications (TMM classification) comprised 8.7% in open surgeries and 20.7% in hybrid and minimally invasive procedures (p=0.031). Pulmonary complications were more common after open esophagectomy (17.4%) compared to hybrid and minimally invasive procedures (7.5%) (p=0.041). Incidence of type 2 and 3 anastomotic leaks was 6.4% in hybrid surgery, 8.6% in open surgery and 10.7%in minimally invasive procedures (p=0.387). Postoperative in-hospital mortality was 8.6% for open esophagectomy, 5.1% for hybrid esophagectomy and 3.5% for minimally invasive procedures (p=0.049). Hospital-stay was 19 days for open esophagectomy and 14 days for hybrid and minimally invasive procedures (p=0.219).
CONCLUSION: Minimally invasive esophagectomy for thoracic esophageal cancer significantly reduces the incidence of postoperative pulmonary complications and intraoperative blood loss, as well as increases the number of removed lymph nodes.
MATERIAL AND METHODS: The study included 175 patients who underwent open, hybrid or minimally invasive McKeown esophagectomy between 2016 and 2023 in 4 cancer centers of the Russian Federation. Traditional open esophagectomy was performed in 69 (39.4%) patients, hybrid - in 78 (44.6%), minimally invasive - in 28 (16%) patients.
RESULTS: Median time of minimally invasive surgery was 395 min [358.25; 436.25], hybrid procedure - 357.5 min [300.00; 403.75], open esophagectomy - 315 min [265.00; 390.00] (p<0.001). Mean blood loss was 175, 150 and 300 ml, respectively (p<0.001). Conversion rate for hybrid interventions was 2.5%, for minimally invasive esophagectomy - 3.5%. Mean number of resected lymph nodes was higher in minimally invasive groups (open - 19.7±7.5; hybrid - 21.3±13.1; minimally invasive esophagectomy - 21.7±12.4 p=0.007). Major postoperative complications (TMM classification) comprised 8.7% in open surgeries and 20.7% in hybrid and minimally invasive procedures (p=0.031). Pulmonary complications were more common after open esophagectomy (17.4%) compared to hybrid and minimally invasive procedures (7.5%) (p=0.041). Incidence of type 2 and 3 anastomotic leaks was 6.4% in hybrid surgery, 8.6% in open surgery and 10.7%in minimally invasive procedures (p=0.387). Postoperative in-hospital mortality was 8.6% for open esophagectomy, 5.1% for hybrid esophagectomy and 3.5% for minimally invasive procedures (p=0.049). Hospital-stay was 19 days for open esophagectomy and 14 days for hybrid and minimally invasive procedures (p=0.219).
CONCLUSION: Minimally invasive esophagectomy for thoracic esophageal cancer significantly reduces the incidence of postoperative pulmonary complications and intraoperative blood loss, as well as increases the number of removed lymph nodes.