Page 157 - Read Online

Parthasarathi et al. Mini-invasive Surg 2019;3:20 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2019.10

Original Article Open Access

Thoraco-laparoscopic Ivor-Lewis esophagectomy:
the most extensive Indian experience

Ramkrishnan Parthasarathi, GHV Raghvendra Gupta, Sandeep C. Sabnis, Palanivelu Praveen Raj,
Palanisamy Senthilnathan, Subbiah Rajapandian, Chinnusamy Palanivelu

Department of Gastrointestinal and Minimal Access Surgery, GEM Hospital and Research Centre, Ramanathapuram, Coimbatore
641045, Tamil Nadu, India.

Correspondence to: Dr. Ramkrishnan Parthasarathi, Department of Gastrointestinal and Minimal Access Surgery GEM Hospital
and Research Centre 45, Pankaja Mills Road, Ramanathapuram, Coimbatore 641045, Tamil Nadu, India.
E-mail: drparthu@geminstitute.in

How to cite this article: Parthasarathi R, Gupta GR, Sabnis SC, Raj PP, Senthilnathan P, Rajapandian S, Palanivelu C. Thoraco-
laparoscopic Ivor-Lewis esophagectomy: the most extensive Indian experience. Mini-invasive Surg 2019;3:20.
http://dx.doi.org/10.20517/2574-1225.2019.10

Received: 20 Mar 2019 First Decision: 17 Jun 2019 Revised: 27 Jun 2019 Accepted: 10 Jul 2019 Published: 20 Jul 2019
Science Editor: Tetsu Fukunaga Copy Editor: Jia-Jia Meng Production Editor: Jing Yu

Abstract
Aim: The overall incidence of adenocarcinoma is on the rise, mainly in the western population. Minimally invasive
thoracolaparoscopic esophagectomy for adenocarcinoma of gastroesophageal junction tumors is being adopted
worldwide, albeit with a slower pace. This study is to share our experience and technical modifications over two
decades.

Methods: This a retrospective data from 2009-2018 at a single center, including all the 143 cases of thora-
colaparoscopic Ivor Lewis esophagectomies performed. There were no exclusions. The study objectives were to
evaluate postoperative recovery, complications, and pathological completeness.

Results: In 11 years, we have performed 532 cases of minimally invasive esophagectomies for both malignant and
benign etiologies. Out of which 143 cases were of Ivor Lewis esophagectomy. The mean age of patients was 64.4 ±
10.86 years, and male to female ratio is 3:1. Out of these cases, 139 (97.20%) were performed for malignancy and 4
(2.79%) for benign cases, which include peptic stricture, sigmoid esophagus. The mean operative time is 457.97 ±
79.35 min. The mean blood loss was 138.08 ± 29.3mL. Out of these cases, the hand-sewn anastomosis was performed
in 72 (50.34%), circular stapler anastomosis in 46 (32.16%) and, linear stapled anastomosis in 25 (17.48%). The
mean lymph node retrieval rate was 22.68 ± 9.49 nodes. The average ICU stay in the postoperative period was 4.68
± 3.95 days, and overall hospital stay was 13.48 ± 7.43 days. Among malignant cases (139), adenocarcinoma in 121

© 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.

www.misjournal.net