Mu JW, Gao SG, Xue Q, Mao YS, Wang DL, Zhao J, Gao YS, Huang JF, He J. Updated experiences with minimally invasive McKeown esophagectomy for esophageal cancer. World J Gastroenterol 2015; 21(45): 12873-12881 [PMID: 26668512 DOI: 10.3748/wjg.v21.i45.12873]
Corresponding Author of This Article
Jie He, MD, PhD, Professor, Department of Thoracic Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. hejie@cicams.ac.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Dec 7, 2015; 21(45): 12873-12881 Published online Dec 7, 2015. doi: 10.3748/wjg.v21.i45.12873
Table 1 Clinical characteristics of patients receiving minimally invasive McKeown esophagectomy n (%)
Clinical variable
Value
Age (yr)
60 (36-79)
Male gender
341 (76.6)
Neoadjuvant radiotherapy
21 (4.7)
Neoadjuvant chemotherapy
30 (6.7)
Location
Upper
96 (21.6)
Middle
292 (65.6)
Lower
57 (12.8)
Type of surgery
Total MIME
375 (84.3)
Hybrid MIME
70 (15.7)
Table 2 Reasons for conversion of patients receiving minimally invasive McKeown esophagectomy
Reason
Number
Rupture of trachea
1
Pleural adhesion
2
Adhesion of abdominal cavity
2
Table 3 Clinical characteristics of patients receiving McKeown esophagectomy n (%)
Clinical variable
Total MIME (n = 375)
Hybrid MIME (n = 70)
Open McKeown esophagectomy (n = 103)
P value
Age (yr)
59 (54-65)
62 (55-67)
56 (52-63)
0.024
Sex (Male)
289 (77.1)
52 (74.3)
84 (81.6)
0.490
BMI (kg/m2)
23 (21-25)
22 (20-25)
23 (20-24)
0.100
Tumor location
< 0.001
Upper
78 (20.8)
18 (25.7)
58 (56.3)
Middle
248 (66.1)
44 (62.9)
39 (37.9)
Lower
49 (13.1)
8 (11.4)
6 (5.8)
Neoadjuvant chemotherapy
21 (5.6)
9 (12.9)
11 (10.7)
0.042
Neoadjuvant radiotherapy
16 (4.3)
5 (7.1)
11 (10.7)
0.043
Table 4 Perioperative outcomes of patients receiving Mckeown esphagectomy n (%)
Clinical variable
Total MIME (n = 375)
Hybrid MIME (n = 70)
Open McKeownesophagectomy (n = 103)
P value
Duration of operation (min)
330 (270-420)
370 (305-435)
340 (320-400)
0.323
Intraoperative blood loss (mL)
100 (100-200)
300 (100-300)
200 (100-300)
0.001
Number of harvested lymph nodes
22 (16-31)
19 (14-29)
25 (19-32)
0.293
AJCC staging
0.085
0
1 (0.3)
1 (1.4)
0 (0)
I
108 (28.8)
19 (27.1)
17 (16.5)
II
172 (45.9)
33 (47.1)
49 (47.6)
III
94 (25.1)
17 (24.3)
37 (35.9)
Differentiation
0.685
High
107 (28.6)
18 (25.7)
35 (34.0)
Middle
209 (55.9)
40 (57.1)
50 (48.5)
Low
58 (15.5)
12 (17.1)
18 (17.5)
Complete resection
374 (99.7)
70 (100)
103 (100)
0.794
Overall Morbidity
73 (19.5)
13 (18.6)
22 (21.6)
0.864
Pulmonary complications
11 (2.9)
2 (2.9)
6 (5.8)
0.347
Leakage
46 (12.3)
10 (14.3)
9 (8.7)
0.493
In-hospital mortality
2 (0.5)
0 (0)
1.0 (0)
0.696
Length of hospital stay (d)
16 (14-24)
18 (16-27)
21 (16-28)
0.078
Table 5 Comparison of perioperative outcomes of patients who underwent total minimally invasive McKeown esophagectomy in the early period n (%)
Clinical variable
Group 1 (n = 60)
Group 2 (n = 60)
Group 3 (n = 60)
P value
Duration of operation (min)
350 (285-450)
303 (270-373)
300 (240-370)
0.004
Intraoperative blood loss (mL)
300 (125-375)
200 (100-300)
100 (100-300)
0.081
Number of harvested lymph nodes
21 (17-30)
22 (16-31)
21 (16-26)
0.866
Overall morbidity
10 (16.7)
13 (21.7)
14 (23.3)
0.643
Pulmonary morbidity
2 (3.3)
3 (5.0)
0 (0)
0.237
Leakage
5 (8.3)
7 (11.7)
11 (18.3)
0.248
In-hospital mortality
1 (1.7)
0 (0)
0 (0)
0.366
Length of hospital stay (d)
17 (14-22)
20 (14-31)
15 (12-21)
0.335
Citation: Mu JW, Gao SG, Xue Q, Mao YS, Wang DL, Zhao J, Gao YS, Huang JF, He J. Updated experiences with minimally invasive McKeown esophagectomy for esophageal cancer. World J Gastroenterol 2015; 21(45): 12873-12881