KEY TAKEAWAYS
- The study aimed to compare the safety and feasibility of single-intercostal totally MIIE with multiple-intercostal MIIE.
- Results showed both techniques are viable, with single-intercostal MIIE offering flexibility for various patients and conditions.
Jinghao Huang and the team aimed to examine the safety and efficacy of single-intercostal versus multiple-intercostal minimally invasive Ivor Lewis esophagectomy (MIIE) for esophageal cancer. They aimed to compare the 2 surgical approaches and assess their respective outcomes.
Researchers collected data from 528 patients who underwent totally MIIE between January 2016 and December 2022. Of these, 294 patients who underwent MIIE (200 single-intercostal and 94 multiple-intercostal) were selected for analysis. Propensity score matching (PSM) was used to create balanced groups for comparison, resulting in 89 matched pairs (178 patients).
The results showed that the single-intercostal group had a shorter operative time (280 min vs. 310 min; P< 0.05) compared to the multiple-intercostal group. Importantly, there were no significant differences in the incidence of major perioperative complications between the 2 groups.
Additionally, the study found no significant differences in the number of lymph nodes harvested or the extent of lymphadenectomy. Patients in the single-intercostal group used less morphine postoperatively and required fewer opioid top-ups.
The study concluded that both single-intercostal and multiple-intercostal MIIE were safe and feasible for esophageal cancer surgery. The single-intercostal technique, like the established multiple-intercostal approach, was appropriate for various patients regardless of age, sex, or tumor characteristics. This provided surgeons with an alternative surgical option that may offer benefits such as reduced postoperative pain and faster recovery.
The study was supported by funds from Key Research and Development Program of Zhejiang Province (No. 2023C03064) and Natural Science Foundation of Zhejiang Province (LZ20H010001).
Source: https://pubmed.ncbi.nlm.nih.gov/39237862/
Huang J, Yu Y, Wu Z, et al. (2024). “Thoracoscopic three-port single versus multiple intercostal for radical resection of esophageal cancer: a retrospective analysis.” BMC Cancer. 2024;24(1):1104. Published 2024 Sep 5. doi:10.1186/s12885-024-12754-0
