Abstract
Background: Thoracoscopic esophagectomy is rapidly and increasingly being used worldwide because it is a less invasive alternative to open esophagectomy. However, few prospective multicenter studies have evaluated its safety profile. This study aimed to evaluate the safety profile of thoracoscopic esophagectomy using perioperative data from the Japan Clinical Oncology Group Study (JCOG0502). Methods: JCOG0502 is a four-arm prospective study comparing esophagectomy with chemoradiotherapy for esophageal cancer, with randomized and patient preference arms. Patients with clinical stage T1bN0M0 esophageal cancer were enrolled until patient accrual was completed. Open or thoracoscopic esophagectomy was selected at the surgeon’s discretion. Perioperative complications were defined as adverse events of ≥grade 2 as per Common Terminology Criteria for Adverse Events ver. 3.0. Results: A total of 379 patients were enrolled between December 2006 and February 2013. Of the 210 patients who underwent surgery, 109 patients underwent open esophagectomy, and 101 patients underwent thoracoscopic esophagectomy. Although thoracoscopic esophagectomy decreased the incidence of postoperative atelectasis (open: 22.0 %, thoracoscopy: 10.9 %; P = 0.041), reoperation was more frequent in the thoracoscopy group (open: 1.8 %, thoracoscopy: 9.9 %; P = 0.016). The incidence of overall complications did not differ between the two groups (open: 44.0 %, thoracoscopy: 44.6 %; P = 1.00). There was one in-hospital death in each group (open: 0.9 %, thoracoscopy: 1.0 %; P = 1.00). Conclusions: Thoracoscopic esophagectomy is a safe procedure with morbidity and mortality comparable with those of open esophagectomy. However, it is associated with a higher frequency of reoperation.
| Original language | English |
|---|---|
| Pages (from-to) | 3519-3526 |
| Number of pages | 8 |
| Journal | Surgical Endoscopy and Other Interventional Techniques |
| Volume | 29 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 2015 Dec 1 |
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Keywords
- Esophageal cancer
- Esophagectomy
- Laparoscopy
- Minimally invasive surgery
- Reoperation
- Thoracoscopy
ASJC Scopus subject areas
- Surgery
Cite this
Evaluation of safety profile of thoracoscopic esophagectomy for T1bN0M0 cancer using data from JCOG0502 : a prospective multicenter study. / Nozaki, Isao; Kato, Ken; Igaki, Hiroyasu; Ito, Yoshinori; Daiko, Hiroyuki; Yano, Masahiko; Udagawa, Harushi; Mizusawa, Junki; Katayama, Hiroshi; Nakamura, Kenichi; Kitagawa, Yuukou.
In: Surgical Endoscopy and Other Interventional Techniques, Vol. 29, No. 12, 01.12.2015, p. 3519-3526.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Evaluation of safety profile of thoracoscopic esophagectomy for T1bN0M0 cancer using data from JCOG0502
T2 - a prospective multicenter study
AU - Nozaki, Isao
AU - Kato, Ken
AU - Igaki, Hiroyasu
AU - Ito, Yoshinori
AU - Daiko, Hiroyuki
AU - Yano, Masahiko
AU - Udagawa, Harushi
AU - Mizusawa, Junki
AU - Katayama, Hiroshi
AU - Nakamura, Kenichi
AU - Kitagawa, Yuukou
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background: Thoracoscopic esophagectomy is rapidly and increasingly being used worldwide because it is a less invasive alternative to open esophagectomy. However, few prospective multicenter studies have evaluated its safety profile. This study aimed to evaluate the safety profile of thoracoscopic esophagectomy using perioperative data from the Japan Clinical Oncology Group Study (JCOG0502). Methods: JCOG0502 is a four-arm prospective study comparing esophagectomy with chemoradiotherapy for esophageal cancer, with randomized and patient preference arms. Patients with clinical stage T1bN0M0 esophageal cancer were enrolled until patient accrual was completed. Open or thoracoscopic esophagectomy was selected at the surgeon’s discretion. Perioperative complications were defined as adverse events of ≥grade 2 as per Common Terminology Criteria for Adverse Events ver. 3.0. Results: A total of 379 patients were enrolled between December 2006 and February 2013. Of the 210 patients who underwent surgery, 109 patients underwent open esophagectomy, and 101 patients underwent thoracoscopic esophagectomy. Although thoracoscopic esophagectomy decreased the incidence of postoperative atelectasis (open: 22.0 %, thoracoscopy: 10.9 %; P = 0.041), reoperation was more frequent in the thoracoscopy group (open: 1.8 %, thoracoscopy: 9.9 %; P = 0.016). The incidence of overall complications did not differ between the two groups (open: 44.0 %, thoracoscopy: 44.6 %; P = 1.00). There was one in-hospital death in each group (open: 0.9 %, thoracoscopy: 1.0 %; P = 1.00). Conclusions: Thoracoscopic esophagectomy is a safe procedure with morbidity and mortality comparable with those of open esophagectomy. However, it is associated with a higher frequency of reoperation.
AB - Background: Thoracoscopic esophagectomy is rapidly and increasingly being used worldwide because it is a less invasive alternative to open esophagectomy. However, few prospective multicenter studies have evaluated its safety profile. This study aimed to evaluate the safety profile of thoracoscopic esophagectomy using perioperative data from the Japan Clinical Oncology Group Study (JCOG0502). Methods: JCOG0502 is a four-arm prospective study comparing esophagectomy with chemoradiotherapy for esophageal cancer, with randomized and patient preference arms. Patients with clinical stage T1bN0M0 esophageal cancer were enrolled until patient accrual was completed. Open or thoracoscopic esophagectomy was selected at the surgeon’s discretion. Perioperative complications were defined as adverse events of ≥grade 2 as per Common Terminology Criteria for Adverse Events ver. 3.0. Results: A total of 379 patients were enrolled between December 2006 and February 2013. Of the 210 patients who underwent surgery, 109 patients underwent open esophagectomy, and 101 patients underwent thoracoscopic esophagectomy. Although thoracoscopic esophagectomy decreased the incidence of postoperative atelectasis (open: 22.0 %, thoracoscopy: 10.9 %; P = 0.041), reoperation was more frequent in the thoracoscopy group (open: 1.8 %, thoracoscopy: 9.9 %; P = 0.016). The incidence of overall complications did not differ between the two groups (open: 44.0 %, thoracoscopy: 44.6 %; P = 1.00). There was one in-hospital death in each group (open: 0.9 %, thoracoscopy: 1.0 %; P = 1.00). Conclusions: Thoracoscopic esophagectomy is a safe procedure with morbidity and mortality comparable with those of open esophagectomy. However, it is associated with a higher frequency of reoperation.
KW - Esophageal cancer
KW - Esophagectomy
KW - Laparoscopy
KW - Minimally invasive surgery
KW - Reoperation
KW - Thoracoscopy
UR - http://www.scopus.com/inward/record.url?scp=84947492692&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84947492692&partnerID=8YFLogxK
U2 - 10.1007/s00464-015-4102-4
DO - 10.1007/s00464-015-4102-4
M3 - Article
C2 - 25676203
AN - SCOPUS:84947492692
VL - 29
SP - 3519
EP - 3526
JO - Surgical Endoscopy and Other Interventional Techniques
JF - Surgical Endoscopy and Other Interventional Techniques
SN - 0930-2794
IS - 12
ER -