Quality of Life after Minimally Invasive Versus Open Esophagectomy

Excerpt

More than 10 years ago, the very successful Dutch clinical trial network published the pivotal trial demonstrating that trans-hiatal esophagectomy was associated with significant advantages compared with traditional transthoracic resection, above all when it came to respiratory complications [1] and the facilitation of the postoperative course. These achievements were not reached at the expense of a less complete operation from a pure oncological perspective. It can be argued that this study represented the first and scientifically well substantiated step towards a less invasive surgical strategy to reduce the post-esophagectomy complication rates. Within the scenario of postoperative complications, those of respiratory nature are the most clinically prevalent and significant. During the same time period, clinical research also delivered convincing data to show that the post-esophagectomy rehabilitation was not only very slow and protracted but expressed itself also as a significant impairment in the patient’s health-related quality of life [2, 3]. In this respect, it also became obvious that the immediate postoperative complications had a detrimental effect on the patient’s quality of life, even when assessed up to 1 year after surgery. …