Dr Pradeep Jain Fortis Hospital - Thoraco Laparoscopic Esophagectomy. Laparoscopic GI and GI Oncology Surgery, Dr. Pradeep Jain Fortis Hospital Review. He gained so much appreciation for his work and has so many happy patients.
4. MIE (concerns)
๏ Safety
Surgery time
Blood loss
Morbidity and Mortality
๏ Recovery
ICU and Hospital Stay
Pain
๏ Oncological out come
LN yield and Resection margins
Survival
๏ Cost
5. Meta analysis
Biere SS, Cuesta MA, van der Peet D, Minimally invasive
versus open esophagectomy for cancer: a systematic
review and meta-analysis. Minerva Chir. 2009
Apr;64(2):121-33.
Nagpal K,Ahmed K,Vats A,Yakoub D, James D,Ashrafian
H, Darzi A, Moorthy K,Athanasiou T. Is minimally invasive
surgery beneficial in the management of esophageal
cancer? A meta-analysis . Surg Endosc. 2010
Jul;24(7):1621-9.
Sgourakis G, Gockel I, Radtke A, Musholt TJ,Timm S, Rink
A,Tsiamis A, Karaliotas C, Lang H Minimally invasive
versus open esophagectomy: meta-analysis of
outcomes. ) Dig Dis Sci. 2010 Nov;55(11):3031-40
6. Randomised Trials
๏ Miguel A. Cuesta, Surya S.A.Y. Biere, Mark I. van Berge
Henegouwen,and Donald L. van der Peet
Randomised trial, Minimally Invasive Oesophagectomy versus open
oesophagectomy for patients with resectable oesophageal cancer.
J Thorac Dis. 2012 October; 4(5): 462โ46
๏ Open versus laparoscopically-assisted oesophagectomy for cancer:
a multicentre randomised controlled phase III trial - the MIRO trial.
Briez N, Piessen G, Bonnetain F, Brigand C, Carrere N, Collet
D, Doddoli C, Flamein R, Mabrut JY, Meunier B, Msika S, Perniceni
T, Peschaud F, Prudhomme M,Triboulet JP, Mariette C.
BMC Center 2011 Jul 23;11:310
21. Mortality
๏ 5/89 30 day mortality
๏ 1/47 MIE (pneumonia with septic
shock)
๏ 4/42 Traditional ( Gastric conduit leak,
Thoracic duct injury,Thoracic
anastomosis leak, Pneumonia with sever
sepsis )
22. Summary
๏ Minimally invasive technique very well
feasible
๏ Immediate outcome better in MIE
๏ Prone position with double lung
anesthesia has less respiratory
complications
๏ Oncological superiority is yet to be
validated in prospective randomised trials