I. Lewis minimally invasive esophagectomy

Abstract

The aim of the study was to improve the direct results of surgical treatment for esophageal diseases by implementing the method of minimally invasive esophagectomy according to I. Lewis. Materials and methods. A total of 92 patients with esophageal diseases were divided into 2 groups: mini-invasive esophagectomy (MIE) and open esophagectomy (OE). The groups were comparable in age, sex, comorbidity and the stage of a disease (P > 0.05). Results. The duration of OE was 270 minutes (IQR 257.5–320.0 minutes), and it was statistically significantly (P < 0.001) less than the duration of MIE – 350 minutes (IQR 326.25–387.50 minutes). The volume of intraoperative blood loss in OE was 400 ml (IQR 300–500 ml) that was statistically significantly (P < 0.001) higher than in MIE – 130 ml (IQR 90–165 ml). The mean value of blood transfusion volume for patients with OE was 283 ml (IQR 261.25–468.50), which was statistically significantly higher (P < 0.001) than in MIE group – 0 (IQR 0.00–246.75). The length of intensive care unit stay in patients after OE was 4 days (IQR 3.00–5.25), in contrast to 2 days in MIE group (IQR 1.00–2.00), P < 0.001. The postoperative period of treatment for patients after OE averaged 12 days (IQR 10.00–15.25), after MIE – 8 days (IQR 8.00–11.00), P < 0.001. Conclusions. Based on the experience of using minimally invasive esophagectomy according to I. Lewis, the safety, efficacy and advantages of the surgical intervention over open esophagectomy have been demonstrated.