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Open Access 02-10-2023 | Esophagus Resection | Thoracic Oncology

Major Intraoperative Complications During Minimally Invasive Esophagectomy

Authors: H. Söderström, MD, J. Moons, RN, MScN, P. Nafteux, MD, PhD, E. Uzun, MD, PhD, P. Grimminger, MD, PhD, M. D. P. Luyer, MD, PhD, G. A. P. Nieuwenhuijzen, MD, M. Nilsson, MD, PhD, M. Hayami, MD, PhD, S. Degisors, MD, G. Piessen, MD, PhD, H. Vanommeslaeghe, MD, E. Van Daele, MD, E. Cheong, MD, Ch A. Gutschow, MD, D. Vetter, MD, N. Schuring, MD, PhD, S. S. Gisbertz, MD, PhD, J. Räsänen, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2023

Abstract

Background

Studies have shown minimally invasive esophagectomy (MIE) to be a feasible surgical technique in treating esophageal carcinoma. Postoperative complications have been extensively reviewed, but literature focusing on intraoperative complications is limited. The main objective of this study was to report major intraoperative complications and 90-day mortality during MIE for cancer.

Methods

Data were collected retrospectively from 10 European esophageal surgery centers. All intention-to-treat, minimally invasive laparoscopic/thoracoscopic esophagectomies with gastric conduit reconstruction for esophageal and GE junction cancers operated on between 2003 and 2019 were reviewed. Major intraoperative complications were defined as loss of conduit, erroneous transection of vascular structures, significant injury to other organs including bowel, heart, liver or lung, splenectomy, or other major complications including intubation injuries, arrhythmia, pulmonary embolism, and myocardial infarction.

Results

Amongst 2862 MIE cases we identified 98 patients with 101 intraoperative complications. Vascular injuries were the most prevalent, 41 during laparoscopy and 19 during thoracoscopy, with injuries to 18 different vessels. There were 24 splenic vascular or capsular injuries, 11 requiring splenectomies. Four losses of conduit due to gastroepiploic artery injury and six bowel injuries were reported. Eight tracheobronchial lesions needed repair, and 11 patients had significant lung parenchyma injuries. There were 2 on-table deaths. Ninety-day mortality was 9.2%.

Conclusions

This study offers an overview of the range of different intraoperative complications during minimally invasive esophagectomy. Mortality, especially from intrathoracic vascular injuries, appears significant.

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Title: Major Intraoperative Complications During Minimally Invasive Esophagectomy
Authors: H. Söderström, MD
J. Moons, RN, MScN
P. Nafteux, MD, PhD
E. Uzun, MD, PhD
P. Grimminger, MD, PhD
M. D. P. Luyer, MD, PhD
G. A. P. Nieuwenhuijzen, MD
M. Nilsson, MD, PhD
M. Hayami, MD, PhD
S. Degisors, MD
G. Piessen, MD, PhD
H. Vanommeslaeghe, MD
E. Van Daele, MD
E. Cheong, MD
Ch A. Gutschow, MD
D. Vetter, MD
N. Schuring, MD, PhD
S. S. Gisbertz, MD, PhD
J. Räsänen, MD, PhD
Publication date: 02-10-2023
Publisher: Springer International Publishing
Keywords: Esophagus Resection
Esophagus Resection
Esophageal Cancer
Esophageal Cancer
Splenectomy
Splenectomy
Thoracoscopy
Published in: Annals of Surgical Oncology / Issue 13/2023
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-023-14340-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Major Intraoperative Complications During Minimally Invasive Esophagectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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