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Minimally Invasive Versus Open Esophagectomy for Esophageal Cancer: A Population-Based Analysis.

Publication ,  Journal Article
Yerokun, BA; Sun, Z; Yang, C-FJ; Gulack, BC; Speicher, PJ; Adam, MA; D'Amico, TA; Onaitis, MW; Harpole, DH; Berry, MF; Hartwig, MG
Published in: Ann Thorac Surg
August 2016

BACKGROUND: The objective of this study was to evaluate outcomes of minimally invasive approaches to esophagectomy using population-level data. METHODS: Multivariable regression modeling was used to determine predictors associated with the use of minimally invasive approaches for patients in the National Cancer Data Base who underwent resection of middle and distal clinical T13N03M0 esophageal cancers from 2010 to 2012. Perioperative outcomes and 3-year survival were compared between propensity-matched groups of patients with esophageal cancer who underwent minimally invasive esophagectomy (MIE) or open esophagectomy (OE). A subgroup analysis was performed to evaluate the impact of using robotic-assisted operations as part of the minimally invasive approach. RESULTS: Among 4,266 patients included, 1,308 (30.6%) underwent MIE. It was more likely to be used in patients treated at academic (adjusted odds ratio [OR], 10.1; 95% confidence interval [CI], 4.2-33.1) or comprehensive cancer facilities (adjusted OR, 6.4; 95% CI, 2.6-21.1). Compared with propensity-matched patients who underwent OE, patients who underwent MIE had significantly more lymph nodes examined (15 versus 13; p = 0.016) and shorter hospital lengths of stay (10 days versus 11 days; p = 0.046) but similar resection margin positivity, readmission, and 30-day mortality (all p > 0.05). Survival was similar between the matched groups at 3 years for both adenocarcinoma and squamous cell carcinoma (p > 0.05). Compared with MIE without robotic assistance, use of a robotic approach was not associated with any significant differences in perioperative outcomes (p > 0.05). CONCLUSIONS: The use of minimally invasive techniques to perform esophagectomy for esophageal cancer is associated with modestly improved perioperative outcomes without compromising survival.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

August 2016

Volume

102

Issue

2

Start / End Page

416 / 423

Location

Netherlands

Related Subject Headings

  • United States
  • Time Factors
  • Thoracoscopy
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Population Surveillance
  • Neoplasm Staging
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Yerokun, B. A., Sun, Z., Yang, C.-F., Gulack, B. C., Speicher, P. J., Adam, M. A., … Hartwig, M. G. (2016). Minimally Invasive Versus Open Esophagectomy for Esophageal Cancer: A Population-Based Analysis. Ann Thorac Surg, 102(2), 416–423. https://doi.org/10.1016/j.athoracsur.2016.02.078
Yerokun, Babatunde A., Zhifei Sun, Chi-Fu Jeffrey Yang, Brian C. Gulack, Paul J. Speicher, Mohamed A. Adam, Thomas A. D’Amico, et al. “Minimally Invasive Versus Open Esophagectomy for Esophageal Cancer: A Population-Based Analysis.Ann Thorac Surg 102, no. 2 (August 2016): 416–23. https://doi.org/10.1016/j.athoracsur.2016.02.078.
Yerokun BA, Sun Z, Yang C-FJ, Gulack BC, Speicher PJ, Adam MA, et al. Minimally Invasive Versus Open Esophagectomy for Esophageal Cancer: A Population-Based Analysis. Ann Thorac Surg. 2016 Aug;102(2):416–23.
Yerokun, Babatunde A., et al. “Minimally Invasive Versus Open Esophagectomy for Esophageal Cancer: A Population-Based Analysis.Ann Thorac Surg, vol. 102, no. 2, Aug. 2016, pp. 416–23. Pubmed, doi:10.1016/j.athoracsur.2016.02.078.
Yerokun BA, Sun Z, Yang C-FJ, Gulack BC, Speicher PJ, Adam MA, D’Amico TA, Onaitis MW, Harpole DH, Berry MF, Hartwig MG. Minimally Invasive Versus Open Esophagectomy for Esophageal Cancer: A Population-Based Analysis. Ann Thorac Surg. 2016 Aug;102(2):416–423.

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

August 2016

Volume

102

Issue

2

Start / End Page

416 / 423

Location

Netherlands

Related Subject Headings

  • United States
  • Time Factors
  • Thoracoscopy
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Population Surveillance
  • Neoplasm Staging
  • Middle Aged
  • Male