Abstract Background Esophageal cancer surgery is challenging with significant morbidity and mortality. Minimally invasive esophagectomy (MIE) has emerged as the preferred approach, offering potential advantages such as reduced morbidity, shorter hospital stays and faster recovery. MIE has been established in our centre since year 2020 and this study explores the perioperative outcomes and challenges in its implementation. Methods A retrospective analysis of prospectively collected data on patients who underwent MIE for esophageal cancer between 2020 and 2024 at a Esophagogastric Cancer Centre in Northern Malaysia. Patient demographics, tumour characteristics, treatment strategies and perioperative outcomes were reviewed. Results A total-of-51 patients underwent MIE. The mean-age was 61 ± 10.9-years, with mean-BMI (25.7 ± 4 kg/m2). 72.5% were adenocarcinoma, predominantly located at the cardioesophageal-junction (51%). Neoadjuvant-therapy was administered to 84.3% of patients. Commonly performed technique was McKeown-MIE (62.7%) with total-thoraco-laparoscopic-surgery without conversion to open (90.2%). Mean operative-time was 595 ± 96.8 minutes, and mean postoperative-hospital stay was 14.7 ± 9.3 days. Postoperative complications occurred in 37.3% of patient, with 23.5% experiencing Clavien-Dindo Grade 3a or higher complications. The anastomotic leak rate was 2% and recurrent laryngeal nerve paresis occurred in 7.8% of cases. Two patients died within 30-days postoperatively. Mean harvested lymph-node was 42.8 ± 20.1. Conclusion MIE is a safe and feasible approach for esophageal cancer, with promising perioperative outcomes comparable to international benchmarks. A multidisciplinary team effort, structured perioperative management, and enhanced recover pathway are essential in improving MIE outcomes.
Tang et al. (Fri,) studied this question.
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