Efficacy of Laparoscopic Gastric Mobilization for Esophagectomy: Comparison with Open Thoraco-abdominal Approach

Background: Less invasive esophagectomy using laparoscopic or thoracoscopic surgery has been reported to have the advantages in short-term recovery over the conventional open thoraco-abdominal approach. However, few reports directly compare laparoscopic gastric mobilization (LGM) and thoracotomy with laparotomy and thoracotomy. The aim of this study was to prove the clinical efficacy of LGM compared with open thoraco-abdominal esophagectomy (OE) in treating thoracic esophageal cancer. Patients and Methods: We retrospectively reviewed 92 consecutive patients who underwent esophagectomy by OE (n = 47) or LGM (n = 45) between 1999 and 2009 at Kochi Medical School (Kochi, Japan) to analyze the surgical outcomes. Results: Patients who underwent LGM had significantly lower operative blood loss (430 versus 1060 mL; P < .001), lower rate of postoperative infections (POIs) (33.3 versus 55.3%; P = .034), shorter length of intensive care unit stay (1 versus 3 days; P < .001), and hospital stay (35 versus 46 days; P = .003). Conclusions: LGM has clinical benefits compared with OE in reduced POIs and faster recovery for patients with esophageal cancer.