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WJOLS

Minimally Invasive Esophagectomy (MIE): Techniques and Outcomes

In MIE, postoperative ventilation time, blood loss, 11. Wu PC, Posner MC. The role of surgery in the management of
transfusion rates, length of ICU and hospital stays are less. oesophageal cancer. Lancet Oncol 2003;4:481-88.
Learning curve is high in MIE. Results of various studies 12. Orringer MB, Marshall B, Iannettoni MD. Eliminating the cervical
esophagogastric anastomotic leak with a side-to-side stapled
show that as the number of cases done are increasing, the anastomosis. J Thorac Cardiovasc Surg 2000;119:277-88.
complications are decreasing. 9,10,14-42 Regarding the survival 13. Lerut T, Coosemans W, De Leyn P, et al. Reflections on three
rate, it has been shown that earlier the stage better the field lymphadenectomy in carcinoma of the esophagus and
survival. The 5-year survival reported by various studies gastroesophageal junction. Hepatogastroenterology 1999;46:
717-25.
were for stage I—83%, stage II—42% and stage III— 14. Collard JM, Lengele B, Otte JB, Kestens PJ. En bloc and standard
16%. esophagectomies by thoracoscopy. Ann Thorac Surg 1993;56:
675-79.
CONCLUSION 15. Martin DJ, Bessell JR, Chew A, Watson DI. Thoracoscopic and
laparoscopic esophagectomy: Initial experience and outcomes.
MIE has been gaining attractiveness since the first report Surg Endosc 2005;19:1597-1601.
nearly two decades ago. Like open surgery, several 16. Suzuki Y, Urashima M, Ishibashi Y, et al. Hand-assisted
techniques exist including totally laparoscopic transhiatal laparoscopic and thoracoscopic surgery (HALTS) in radical
or transthoracic resections as well as combination, or hybrid esophagectomy with three-field lymphadenectomy for thoracic
esophageal cancer. Eur J Surg Oncol 2005;31:1166-74.
techniques. Much as with open esophageal surgery, no 17. Palanivelu C, Prakash A, Senthilkumar R, et al. Minimally
consensus has been reached regarding the superiority of invasive esophagectomy: Thoracoscopic mobilization of the
any particular MIE adaptation. By reducing perioperative esophagus and mediastinal lymphadenectomy in prone
morbidity and recovery time, and by maintaining the position—experience of 130 patients. J Am Coll Surg 2006;203:
7-16.
oncological principles, MIE is a safe alternative for open 18. Buess G, Kaiser J, Manncke K, et al. Endoscopic microsurgical
procedures under experienced hands. Initial outcomes of dissection of the esophagus (EMDE). Int Surg 1997;82:109-12.
the minimally invasive approach appear to be atleast 19. Bonavina L, Incarbone R, Bona D, Peracchia A. Esophagectomy
equivalent, and the promise of potential benefits a tangible via laparoscopy and transmediastinal endodissection.
possibility. J Laparoendosc Adv Surg Tech A 2004;14:13-16.
20. Galvani CA, Gorodner MV, Moser F, et al. Robotically assisted
laparoscopic transhiatal esophagectomy. Surg Endosc
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