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September 10, 2025

A Study Comparison of Open and Minimally Invasive Esophagectomy for Esophageal Cancer at National Cancer Center of Mongolia

Key Points

This study shows that open esophagectomy, MIE, and hybrid MIE are clinically safe alternatives for esophageal cancer.
Among 108 patients, hybrid MIE had a higher incidence of complications and a longer hospital stay compared to other techniques.
Statistical analysis was performed on data from a retrospective study evaluating short-term outcomes in esophageal surgeries.
Findings indicate that while MIE may be preferable when suitable, McKeown esophagectomy remains oncologically sound.

Abstract

Abstract Background Minimally invasive esophagectomy is increasingly performed for esophageal or gastroesophageal junction cancer (EGJ), with the advantages of improved peri-operative outcomes in comparison with open esophagectomy. In NCCM (National Cancer Center of Mongolia), the thoracic surgery department responsible for esophageal cancer surgery, even though it is the most complicated and has a high incidence of mortality, we use the Minimally invasive technique. In two (Ivor Lewis esophagectomy) and Three fields (Mc Keown esophagectomy) surgeries we do open esophagectomy, hybrid and pure MIE (minimally Invasive Esophagectomy) techniques. In this study, we compare between two different methods of esophageal surgery by three techniques. Methods Data was collected from E-Health program, statistical analysis were performed on SPSS 25 software program. Retrospective study evaluating short-term outcomes of open, MIE and hybrid MIE in patients with resectable esophageal and EGJ cancer. Main parameters included 30-day in hospital mortality and R classification. Results From 209 patients who underwent esophageal surgery,101 patients was excluded due to the different types of surgeries performed and other reasons. Age, sex, and the cancer stage between the 3 groups were not statistically different. Among 108 patients included, 73 underwent MIE and Hybrid MIE. Compared with propensity-matched patients who underwent OE and MIE, patients who underwent Hybrid MIE had a significantly higher incidence of complications, longer hospital stays and higher incidence of 30-day mortality. McKeown esophagectomy was associated 100% resection margin negativity. Compared with OE, MIE and Hybrid MIE was not associated with any significant differences in peri-operative outcomes. Conclusion This study suggests that OE, MIE and Hybrid MIE are comparable with the respect to clinical safety. Pure MIE may be a better option when clinically suitable but McKeown esophagectomy would be a better oncologically safe technique.

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