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Comparison of laparoscopic inversion esophagectomy and open transhiatal esophagectomy for high-grade dysplasia and stage I esophageal adenocarcinoma
Archives of Surgery, 07/24/09
Perry KA et al. - In a study to assess whether perioperative outcomes of laparoscopic inversion esophagectomy (LIE) are comparable to those of open transhiatal esophagectomy (THE), it appears that LIE is a safe and effective approach to treatment of high-grade dysplasia and early esophageal adenocarcinoma. Compared with THE, LIE decreases operative blood loss and length of hospital stay without increasing the operative time, morbidity, or mortality related to esophagectomy.
Methods- 21 consecutive pts underwent LIE for high-grade dysplasia or clinical stage I esophageal cancer.
- Pts were compared with 21 stage-matched control pts treated with THE.
- Main outcomes were operative time, blood loss, length of hospital stay, perioperative complications, and disease-free survival.
- Mean operative times for LIE (399 mins) and THE (407 mins) were not significantly different.
- Pts undergoing LIE had significantly lower intraoperative blood loss (168 mL) and overall length of hospital stay (10 days) compared with those in the THE group (526 mL and 14 days, respectively).
- Complication rates were not significantly different between the groups.
- With a median follow-up of 29 mos, there has been 1 systemic recurrence in the LIE group.
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