Minimally Invasive Approach To Esophagectomy May Lower Morbidity And Quicken Return To Daily Activity, University Of Pittsburgh Medical Center Surgeons Report
PITTSBURGH, September 14, 2000 — Minimally invasive surgery for esophagectomy (removal of the esophagus) may lower the morbidity often associated with open esophagectomy, according to a study conducted by surgeons at the University of Pittsburgh Medical Center. The study is published in the September issue of Annals of Thoracic Surgery.
The study was conducted from August 1996 to September 1999. Surgeons studied the outcomes of 77 patients who underwent minimally invasive procedures for esophagectomy. Of those 77, 50 were men and 27 were women, with an average age of 66. The average hospital stay was about seven days with no operative or hospital mortalities.
"The results of this study show that minimally invasive esophagectomy is technically feasible and safe in a center where surgeons have extensive experience in both minimally invasive and open esophagectomy," said James Luketich, M.D., principal investigator of the study, assistant professor of surgery and section head of thoracic surgery.
Esophagectomy remains the standard level of care for localized esophageal cancer. Surgical options include thoracotomy, which involves an incision to open the chest wall, laparotomy, a procedure that involves a surgical incision through the abdomen, or both. These procedures, however, can be associated with significant morbidity and mortality and a delay in the patient’s return to routine activities.
"Open surgery should remain the standard until future studies conclusively demonstrate advantages of minimally invasive approaches," stressed Dr. Luketich, who also serves as co-director of the University of Pittsburgh Cancer Institute’s Lung Cancer Center and the Mark Ravitch/Leon C. Hirsch Center for Minimally Invasive Surgery. "However, advances in minimally invasive instrumentation, increasing applications of less invasive techniques to a variety of disorders and the potential for less morbidity are encouraging surgeons to explore the role of less invasive techniques for this type of procedure."
More than 12,000 individuals develop esophageal cancer each year in the United States, and the incidence is increasing rapidly. The only known risk factor for this rising incidence is chronic heartburn. Esophageal cancer can develop in any part of the esophagus and in many cases, spreads to the windpipe, the large blood vessels in the chest, the lungs, liver, stomach and other parts of the body. Signs of esophageal cancer include difficulty swallowing, weight loss, loss of appetite, coughing, hoarseness, bone pain and shortness of breath.
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