Initial experience with uniportal video-assisted thoracic surgery esophagectomy

Dania Nachira, Elisa Meacci, Maria Giovanna Mastromarino, Luca Pogliani, Edoardo Zanfrini, Amedeo Iaffaldano, Leonardo Petracca-Ciavarella, Marco Chiappetta, Maria Teresa Congedo, Maria Letizia Vita, Venanzio Porziella, Stefano Margaritora

Research output: Contribution to journalArticle

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Abstract

Background: Multiportal thoracoscopic approach is already a well standardized procedure for minimally invasive esophagectomy (MIE); conversely very few reports have been published about uniportal video-assisted thoracic surgery (VATS) technique till now. We present our preliminary experience with uniportal VATS esophagectomy, evaluating short-term outcomes as perioperative mortality, complications, oncological radicality, postoperative pain and cosmetic results. Methods: From December 2016 to November 2017, the prospectively collected clinical data of 12 patients, who underwent uniportal VATS esophagectomy and reconstruction with a stomach conduit, according to McKeown technique, were reviewed and outcomes evaluated. Results: The mean age of population was 60.67±8.61 years. Ten (83.3%) patients were males. The main histological type was a squamous cell carcinoma in six patients (50%). No patient had a local recurrence. After 4.33±3.31 months 10 patients (83.3%) were alive with no evidence of disease; 2 (16.7%) patients died of other causes. Two (16.7%) patients developed an anastomotic leak (treated conservatively) and one (8.3%) patient a chylothorax (which required a surgical treatment). The mean operative time of uniportal VATS esophagectomy was 104.67±20.66 min. Mean number of thoracic nodes removed was 10.44±3.94. Postoperative hospitalization was 15.73±14.29 days (median of 9 days). The mean level of pain was 1.92±0.90 in first postoperative day with a duration of 2.25±1.54 days. Cosmetic result was 2.42±0.79 on a 3-point scale. Conclusions: Uniportal VATS esophagectomy seems to be a safe, feasible and effective alternative to multiportal VATS in terms of operative time, postoperative mortality, hospital stay and oncological outcomes. Less postoperative pain and better cosmetic results seem to be some advantages in favor of Uniportal VATS, however further studies with longer follow-up are claimed.

Original languageEnglish
Pages (from-to)S3686-S3695
JournalJournal of Thoracic Disease
Volume10
DOIs
Publication statusPublished - Nov 1 2018

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Video-Assisted Thoracic Surgery
Esophagectomy
Cosmetics
Operative Time
Postoperative Pain
Chylothorax
Anastomotic Leak
Mortality
Squamous Cell Carcinoma
Length of Stay
Stomach
Hospitalization
Thorax
Recurrence
Pain

Keywords

  • Esophageal cancer
  • Esophagectomy
  • Uniportal video assisted thoracoscopy (uniportal VATS)

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Initial experience with uniportal video-assisted thoracic surgery esophagectomy. / Nachira, Dania; Meacci, Elisa; Mastromarino, Maria Giovanna; Pogliani, Luca; Zanfrini, Edoardo; Iaffaldano, Amedeo; Petracca-Ciavarella, Leonardo; Chiappetta, Marco; Congedo, Maria Teresa; Vita, Maria Letizia; Porziella, Venanzio; Margaritora, Stefano.

In: Journal of Thoracic Disease, Vol. 10, 01.11.2018, p. S3686-S3695.

Research output: Contribution to journalArticle

Nachira, D, Meacci, E, Mastromarino, MG, Pogliani, L, Zanfrini, E, Iaffaldano, A, Petracca-Ciavarella, L, Chiappetta, M, Congedo, MT, Vita, ML, Porziella, V & Margaritora, S 2018, 'Initial experience with uniportal video-assisted thoracic surgery esophagectomy', Journal of Thoracic Disease, vol. 10, pp. S3686-S3695. https://doi.org/10.21037/jtd.2018.04.17
Nachira, Dania ; Meacci, Elisa ; Mastromarino, Maria Giovanna ; Pogliani, Luca ; Zanfrini, Edoardo ; Iaffaldano, Amedeo ; Petracca-Ciavarella, Leonardo ; Chiappetta, Marco ; Congedo, Maria Teresa ; Vita, Maria Letizia ; Porziella, Venanzio ; Margaritora, Stefano. / Initial experience with uniportal video-assisted thoracic surgery esophagectomy. In: Journal of Thoracic Disease. 2018 ; Vol. 10. pp. S3686-S3695.
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AU - Meacci, Elisa

AU - Mastromarino, Maria Giovanna

AU - Pogliani, Luca

AU - Zanfrini, Edoardo

AU - Iaffaldano, Amedeo

AU - Petracca-Ciavarella, Leonardo

AU - Chiappetta, Marco

AU - Congedo, Maria Teresa

AU - Vita, Maria Letizia

AU - Porziella, Venanzio

AU - Margaritora, Stefano

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N2 - Background: Multiportal thoracoscopic approach is already a well standardized procedure for minimally invasive esophagectomy (MIE); conversely very few reports have been published about uniportal video-assisted thoracic surgery (VATS) technique till now. We present our preliminary experience with uniportal VATS esophagectomy, evaluating short-term outcomes as perioperative mortality, complications, oncological radicality, postoperative pain and cosmetic results. Methods: From December 2016 to November 2017, the prospectively collected clinical data of 12 patients, who underwent uniportal VATS esophagectomy and reconstruction with a stomach conduit, according to McKeown technique, were reviewed and outcomes evaluated. Results: The mean age of population was 60.67±8.61 years. Ten (83.3%) patients were males. The main histological type was a squamous cell carcinoma in six patients (50%). No patient had a local recurrence. After 4.33±3.31 months 10 patients (83.3%) were alive with no evidence of disease; 2 (16.7%) patients died of other causes. Two (16.7%) patients developed an anastomotic leak (treated conservatively) and one (8.3%) patient a chylothorax (which required a surgical treatment). The mean operative time of uniportal VATS esophagectomy was 104.67±20.66 min. Mean number of thoracic nodes removed was 10.44±3.94. Postoperative hospitalization was 15.73±14.29 days (median of 9 days). The mean level of pain was 1.92±0.90 in first postoperative day with a duration of 2.25±1.54 days. Cosmetic result was 2.42±0.79 on a 3-point scale. Conclusions: Uniportal VATS esophagectomy seems to be a safe, feasible and effective alternative to multiportal VATS in terms of operative time, postoperative mortality, hospital stay and oncological outcomes. Less postoperative pain and better cosmetic results seem to be some advantages in favor of Uniportal VATS, however further studies with longer follow-up are claimed.

AB - Background: Multiportal thoracoscopic approach is already a well standardized procedure for minimally invasive esophagectomy (MIE); conversely very few reports have been published about uniportal video-assisted thoracic surgery (VATS) technique till now. We present our preliminary experience with uniportal VATS esophagectomy, evaluating short-term outcomes as perioperative mortality, complications, oncological radicality, postoperative pain and cosmetic results. Methods: From December 2016 to November 2017, the prospectively collected clinical data of 12 patients, who underwent uniportal VATS esophagectomy and reconstruction with a stomach conduit, according to McKeown technique, were reviewed and outcomes evaluated. Results: The mean age of population was 60.67±8.61 years. Ten (83.3%) patients were males. The main histological type was a squamous cell carcinoma in six patients (50%). No patient had a local recurrence. After 4.33±3.31 months 10 patients (83.3%) were alive with no evidence of disease; 2 (16.7%) patients died of other causes. Two (16.7%) patients developed an anastomotic leak (treated conservatively) and one (8.3%) patient a chylothorax (which required a surgical treatment). The mean operative time of uniportal VATS esophagectomy was 104.67±20.66 min. Mean number of thoracic nodes removed was 10.44±3.94. Postoperative hospitalization was 15.73±14.29 days (median of 9 days). The mean level of pain was 1.92±0.90 in first postoperative day with a duration of 2.25±1.54 days. Cosmetic result was 2.42±0.79 on a 3-point scale. Conclusions: Uniportal VATS esophagectomy seems to be a safe, feasible and effective alternative to multiportal VATS in terms of operative time, postoperative mortality, hospital stay and oncological outcomes. Less postoperative pain and better cosmetic results seem to be some advantages in favor of Uniportal VATS, however further studies with longer follow-up are claimed.

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