- In a real-world analysis, minimally invasive esophagectomy (MIE) was associated with increased pulmonary complications and reoperations compared with open procedures.
Why this matters
- These results conflict with those of the TIME trial, which found fewer pulmonary complications with MIE.
- Analysis from the original TIME trial (n=115), along with data from the Dutch Upper GI Cancer Audit (DUCA) data set (n=4605).
- Funding: National Institutes of Health Research.
- In the TIME trial, MIE was associated with fewer pulmonary complications (OR, 0.19; 95% CI, 0.06-0.61).
- After adjustment for patient and tumor factors and year of surgery, an analysis of the DUCA national data set showed that compared with open surgery, MIE was associated (ORs; 95% CIs) with more postoperative complications (1.36; 1.19-1.57), specifically:
- Pulmonary complications: 1.50 (1.29-1.74).
- Reoperation: 1.74 (1.42-2.14).
- Complications graded Clavien-Dindo ≥3: 1.63 (1.15-2.31).
- Length of hospital stay: coefficient, 4.80 (4.15-5.45).
- MIE was associated with greater average lymph node harvest (coefficient, 3.31; 95% CI, 1.62-5.00).
- Patients who received neoadjuvant chemoradiotherapy had similar trends with MIE compared with open surgery.
- Retrospective analysis.