caa a22 4500 44533441X CHVBK 20180317142749.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1245/s10434-011-1702-7 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1702-7 Minimally Invasive Esophagectomy is Safe and Effective Following Neoadjuvant Chemoradiation Therapy [Elektronische Daten] [Kfir Ben-David, George Rossidis, Robert Zlotecki, Stephen Grobmyer, Juan Cendan, George Sarosi, Steven Hochwald] Background: Minimally invasive esophagectomy (MIE) is technically demanding, and implementation has been hindered by a steep learning curve. Despite widespread concern about the successful performance of this procedure following neoadjuvant chemoradiotherapy (NACR) treatment, we hypothesized that safe and effective MIE could be performed in this setting. Materials and Methods: We reviewed our prospective database of patients undergoing MIE for esophageal cancer at our institution between January 2008 and February 2010. We analyzed the association of NACR on perioperative outcomes and compared them with those patients undergoing MIE without NACR. NACR was used in ≥T2 or N+ tumors. Results: A total of 61 consecutive patients underwent a planned MIE. A complete MIE or hybrid procedure was performed in 58 patients (95%), while 3 patients were unresectable. Median age was 67years (range 38-85). Anastomoses were performed in the cervical region in 47 patients (81%) while 11 patients had an anastomosis in the right chest. Serious complications included: 3 cervical anastomotic leaks (5%), 2 thoracic duct leaks (4%), 12 pneumonias (21%), 10 atrial fibrillations (18%), and 1 death in a patient not undergoing NACR. NACR was used in 41 patients. There was no significant difference in estimated blood loss (EBL), complications, or negative pathologic margins in patients undergoing NACR with MIE vs. MIE alone (P=NS). Median number of lymph nodes excised and PostOp LOS was 15 and 11 in patients undergoing NACR compared with 13 and 9 in those undergoing MIE alone (P=NS). Conclusion: MIE is safe following NACR. Excellent results can be achieved with this operation in patients with advanced tumors. Society of Surgical Oncology, 2011 Ben-David Kfir Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA aut Rossidis George Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA aut Zlotecki Robert Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA aut Grobmyer Stephen Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA aut Cendan Juan Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA aut Sarosi George Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA aut Hochwald Steven Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA aut Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3324-3329 1068-9265 18:12<3324 2011 18 10434 https://doi.org/10.1245/s10434-011-1702-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1702-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ben-David Kfir Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA aut NATIONALLICENCE 700 1- Rossidis George Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA aut NATIONALLICENCE 700 1- Zlotecki Robert Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA aut NATIONALLICENCE 700 1- Grobmyer Stephen Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA aut NATIONALLICENCE 700 1- Cendan Juan Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA aut NATIONALLICENCE 700 1- Sarosi George Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA aut NATIONALLICENCE 700 1- Hochwald Steven Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3324-3329 1068-9265 18:12<3324 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer