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de Pascale et al. Mini-invasive Surg 2019;3:18 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2019.04

Original Article Open Access

Totally minimally invasive Ivor-Lewis
esophagectomy: initial single center experience

Stefano de Pascale , Federico Ghidinelli , Alessandra Nella Piccioli , Simona Borin , Uberto Fumagalli
2
1
1
1
Romario 1
1 European Institute of Oncology IRCCS, Milan 20141, Italy.
2 Spedali Civili di Brescia, Brescia 25123, Italy.
Correspondence to: Dr. Stefano de Pascale, European Institute of Oncology IRCCS, Milan 20141, Italy.
E-mail: stefano.depascale@gmail.com
How to cite this article: de Pascale S, Ghidinelli F, Piccioli AN, Borin S, Fumagalli Romario U. Totally minimally invasive Ivor-Lewis
esophagectomy: initial single center experience. Mini-invasive Surg 2019;3:18. http://dx.doi.org/10.20517/2574-1225.2019.04
Received: 18 Jan 2019 First Decision: 18 Mar 2019 Revised: 1 Apr 2019 Accepted: 30 Apr 2019 Published: 26 Jun 2019

Science Editor: Tetsu Fukunaga Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Aim: Minimally invasive techniques for esophagectomy decrease cardiopulmonary complications and guarantee
better quality of life (QoL) compared to open techniques, without compromising oncological radicality. This
retrospective study compares the short-term and QoL outcomes of hybrid Ivor Lewis (HIL) and totally minimally
invasive Ivor Lewis (TMIIL).

Methods: Patients with cancer of the distal esophagus and esophagogastric junction were included into (HIL) and
(TMIIL) groups in the period January 2017-July 2018. General features, intraoperative and postoperative results
were analyzed. The surgical radicality and number of resected nodes were also evaluated. QoL was determined
preoperatively and at 7 and 90 days postoperatively with EORTC QLQ-C30 questionnaire.

Results: General features were similar in the TMIIL and HIL groups, which contained 13 and 14 patients, respectively.
Median intervention duration was 360 min (range: 240-420) for TMIIL and 330 min (range: 240-400) for HIL
(P = 0.0647). Median blood losses were similar for TMIIL and HIL at 100 mL (range: 50-400) and 175 mL (range:
50-350), respectively (P = 0.0831); pulmonary complications were 15% and 14% (P = 1) and leaks were 7% and 14%
(P = 1) for TMIIL and HIL, respectively.

Conclusion: Our experience suggests that TMIIL esophagectomy appears to give results similar to HIL and positively
influences the QoL within 90 days after surgery. Duration of surgery and anastomotic leaks are the key elements

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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