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Surgical outcomes after totally minimally invasive Ivor Lewis esophagectomy. A systematic review and meta-analysis.
Casas, María A; Angeramo, Cristian A; Bras Harriott, Camila; Schlottmann, Francisco.
Afiliação
  • Casas MA; Department of Surgery, Hospital Alemán of Buenos Aires, Argentina.
  • Angeramo CA; Department of Surgery, Hospital Alemán of Buenos Aires, Argentina.
  • Bras Harriott C; Department of Surgery, Hospital Alemán of Buenos Aires, Argentina.
  • Schlottmann F; Department of Surgery, Hospital Alemán of Buenos Aires, Argentina. Electronic address: fschlottmann@hospitalaleman.com.
Eur J Surg Oncol ; 48(3): 473-481, 2022 Mar.
Article em En | MEDLINE | ID: mdl-34955315
BACKGROUND: A transthoracic esophagectomy is associated with high rates of morbidity. Minimally invasive esophagectomy has emerged to decrease such morbidity. The aim of this study was to accurately determine surgical outcomes after totally minimally invasive Ivor-Lewis Esophagectomy (TMIE). METHODS: A systematic literature search was performed to identify original articles analyzing patients who underwent TMIE. Main outcomes included overall morbidity, major morbidity, pneumonia, arrhythmia, anastomotic leak, chyle leak, and mortality. A meta-analysis was conducted to estimate the overall weighted proportion and its 95% confidence interval (CI) for each analyzed outcome. RESULTS: A total of 5619 patients were included for analysis; 4781 (85.1%) underwent a laparoscopic/thoracoscopic esophagectomy and 838 (14.9%) a robotic-assisted esophagectomy. Mean age of patients was 63.5 (55-67) years and 75.8% were male. Overall morbidity and major morbidity rates were 39% (95% CI, 33%-45%) and 20% (95% CI, 13%-28%), respectively. Postoperative pneumonia and arrhythmia rates were 10% (95% CI, 8%-13%) and 12% (95% CI, 8%-17%), respectively. Anastomotic leak rate across studies was 8% (95% CI, 6%-10%). Chyle leak rate was 3% (95% CI, 2%-5%). Mortality rate was 2% (95% CI, 2%-2%). Median ICU stay and length of hospital stay were 2 (1-4) and 11.2 (7-20) days, respectively. CONCLUSIONS: Totally minimally invasive Ivor-Lewis esophagectomy is a challenging procedure with high morbidity rates. Strategies to enhance postoperative outcomes after this operation are still needed.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia / Neoplasias Esofágicas / Laparoscopia Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies / Systematic_reviews Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Surg Oncol Assunto da revista: NEOPLASIAS Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Argentina País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia / Neoplasias Esofágicas / Laparoscopia Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies / Systematic_reviews Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Surg Oncol Assunto da revista: NEOPLASIAS Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Argentina País de publicação: Reino Unido