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90th Annual Meeting Abstracts


Feasibility of Minimally Invasive Esophagectomy following Neoadjuvant Chemoradiation.
*Jaromir Kohout, MD, *John A Federico, MD, *Alicia A McKelvey, MD, *Thomas Fabian, MD
Hospital of St Raphael, New Haven, CT

Objective:
Evaluate the feasibility and outcomes of minimally invasive esophagectomy (MIE) following chemoradiation.
Design:
Retrospective case series review of patients undergoing MIE after chemoradiation utilizing a prospectively maintained database.
Setting:
A single teaching hospital experience
Patients:
Twenty consecutive patients underwent MIE following neoadjuvant chemoradiation between June 2005 to December 2008.
Interventions:
Minimally invasive esophagectomy following course of neoadjuvant chemoradiation.

Main Outcome Measures:
Technical feasibility of MIE following chemoradiation: complications, length of hospital stay, mortality, conversion rates.
Results:
Of the 20 patients 16 were males and 4 females with a median age of 60 years (range 26-74). Adenocarcinoma was the most common cancer (17) followed by squamous cell carcinoma (2) and small cell carcinoma (1). Median estimated blood loss was 200cc (range 150-600), median lymph node procurement was 13 (range 7-22). Conversions to open occurred in 2 (10%) of 20 patients. Complications occurred in 9 (45%) and in-hospital mortality was 1 (5%) of 20 patients. Median length of stay was 10 days (range 7-52).
Conclusions:
MIE is utilized with increasing popularity in esophageal malignancies in the hopes of minimizing surgical morbidity and mortality. Despite this there is little data to support its use following neoadjuvant chemoradiation. This study confirms the feasibility of these procedures in the setting of experienced surgeons and demonstrates acceptable outcomes.


 

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