Minimally invasive esophagectomy versus open esophagectomy, a symptom assessment study

R. Mehran, D. Rice, Randa El-Zein, J. L. Huang, A. Vaporciyan, A. Goodyear, A. Mehta, A. Correa, G. Walsh, J. Roth, S. Swisher, W. Hofstetter

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Minimally invasive esophagectomy (MIE) is used with hope to decrease the morbidity associated with an open esophagectomy. Reflux and dumping syndromes are the most important functional complaints in patients after esophagectomy. This study compares the functional benefits of MIE with open esophagectomy. The study enrolled patients who underwent either minimally invasive or open esophagectomy for cancer between 2004 and 2009. No patients in the MIE group had a pyloroplasty or myotomy. Each patient in the MIE group was paired to a patient in the open esophagectomy group via propensity matching. Matching variables included age, race, gender, preoperative treatment, history of prior cancer, American Society of Anesthesiologists Risk Scale, performance status, clinical stage, body mass index, histology, level of anastomosis, and time elapsed since surgery. The patients were asked to answer 26 questions about their reflux and dumping using validated questionnaires. A total of 181 patients were included in the study. From this group, 44 pairs of patients were created and used for the analysis. The median follow-up was 12.1 months for the MIE group and 18.3 months for the open group. The reflux score was slightly worse in the MIE group (5.5 versus 3.5, P= 0.021). There was no difference in the dumping symptoms between the two groups. The most common complaints seen in the dumping questionnaire in almost one-third of all patients were early satiety, abdominal discomfort, nausea, and diarrhea. Of the patients, 77% were satisfied or very satisfied with their condition in the MIE group compared with 93% in the open group (P= 0.287). Reflux, dumping, and overall satisfaction after MIE without pyloroplasty are comparable with those obtained after open esophagectomy with a pyloric drainage procedure.

Original languageEnglish (US)
Pages (from-to)147-152
Number of pages6
JournalDiseases of the Esophagus
Volume24
Issue number3
DOIs
StatePublished - Apr 1 2011

Keywords

  • Dumping
  • Esophageal cancer
  • Esophagectomy
  • Minimally invasive surgery
  • Quality of life
  • Reflux

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint Dive into the research topics of 'Minimally invasive esophagectomy versus open esophagectomy, a symptom assessment study'. Together they form a unique fingerprint.

Cite this