TY - JOUR
T1 - Major Intraoperative Complications During Minimally Invasive Esophagectomy
AU - Söderström, H.
AU - Moons, J.
AU - Nafteux, P.
AU - Uzun, E.
AU - Grimminger, P.
AU - Luyer, M. D. P.
AU - Nieuwenhuijzen, G. A. P.
AU - Nilsson, M.
AU - Hayami, M.
AU - Degisors, S.
AU - Piessen, G.
AU - Vanommeslaeghe, H.
AU - van Daele, E.
AU - Cheong, E.
AU - Gutschow, Ch A.
AU - Vetter, D.
AU - Schuring, N.
AU - Gisbertz, S. S.
AU - Räsänen, J.
N1 - Funding Information: Dr. Misha Luyer: Grant and consultant fees for Medtronic; grant from Galvani. Dr. Guillaume Piessen: Consulting fees for BMS, MSD, Nestlé; Travel expenses from Medtronic Publisher Copyright: © 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - Background: Studies have shown minimally invasive esophagectomy (MIE) to be a feasible surgical technique in treating esophageal carcinoma. Postoperative complications have been extensively reviewed, but literature focusing on intraoperative complications is limited. The main objective of this study was to report major intraoperative complications and 90-day mortality during MIE for cancer. Methods: Data were collected retrospectively from 10 European esophageal surgery centers. All intention-to-treat, minimally invasive laparoscopic/thoracoscopic esophagectomies with gastric conduit reconstruction for esophageal and GE junction cancers operated on between 2003 and 2019 were reviewed. Major intraoperative complications were defined as loss of conduit, erroneous transection of vascular structures, significant injury to other organs including bowel, heart, liver or lung, splenectomy, or other major complications including intubation injuries, arrhythmia, pulmonary embolism, and myocardial infarction. Results: Amongst 2862 MIE cases we identified 98 patients with 101 intraoperative complications. Vascular injuries were the most prevalent, 41 during laparoscopy and 19 during thoracoscopy, with injuries to 18 different vessels. There were 24 splenic vascular or capsular injuries, 11 requiring splenectomies. Four losses of conduit due to gastroepiploic artery injury and six bowel injuries were reported. Eight tracheobronchial lesions needed repair, and 11 patients had significant lung parenchyma injuries. There were 2 on-table deaths. Ninety-day mortality was 9.2%. Conclusions: This study offers an overview of the range of different intraoperative complications during minimally invasive esophagectomy. Mortality, especially from intrathoracic vascular injuries, appears significant.
AB - Background: Studies have shown minimally invasive esophagectomy (MIE) to be a feasible surgical technique in treating esophageal carcinoma. Postoperative complications have been extensively reviewed, but literature focusing on intraoperative complications is limited. The main objective of this study was to report major intraoperative complications and 90-day mortality during MIE for cancer. Methods: Data were collected retrospectively from 10 European esophageal surgery centers. All intention-to-treat, minimally invasive laparoscopic/thoracoscopic esophagectomies with gastric conduit reconstruction for esophageal and GE junction cancers operated on between 2003 and 2019 were reviewed. Major intraoperative complications were defined as loss of conduit, erroneous transection of vascular structures, significant injury to other organs including bowel, heart, liver or lung, splenectomy, or other major complications including intubation injuries, arrhythmia, pulmonary embolism, and myocardial infarction. Results: Amongst 2862 MIE cases we identified 98 patients with 101 intraoperative complications. Vascular injuries were the most prevalent, 41 during laparoscopy and 19 during thoracoscopy, with injuries to 18 different vessels. There were 24 splenic vascular or capsular injuries, 11 requiring splenectomies. Four losses of conduit due to gastroepiploic artery injury and six bowel injuries were reported. Eight tracheobronchial lesions needed repair, and 11 patients had significant lung parenchyma injuries. There were 2 on-table deaths. Ninety-day mortality was 9.2%. Conclusions: This study offers an overview of the range of different intraoperative complications during minimally invasive esophagectomy. Mortality, especially from intrathoracic vascular injuries, appears significant.
KW - Complication
KW - Esophageal cancer
KW - Minimally invasive esophagectomy
KW - Surgical outcome
UR - http://www.scopus.com/inward/record.url?scp=85173081090&partnerID=8YFLogxK
U2 - https://doi.org/10.1245/s10434-023-14340-3
DO - https://doi.org/10.1245/s10434-023-14340-3
M3 - Article
C2 - 37782412
SN - 1068-9265
VL - 30
SP - 8244
EP - 8250
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 13
ER -