Modified McKeown minimally invasive esophagectomy for esophageal cancer: A retrospective study of 376 patients at a single institution

Objective

Minimally invasive esophagectomy (MIE) was first implemented in 1992 and various MIEs have been performed subsequently. The modified McKeown MIE that includes thoracoscopic and laparoscopic procedures with left neck anastomosis has been implemented in our institution since 2006. We herein report our first 5-year experience in 376 consecutive patients undergone the modified McKeown MIE for esophageal cancer to evaluate perioperative outcomes and survival.

Methods

A total of 376 patients underwent a modified McKeown MIE from March 2016 to March 2021 at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. Patient demographics and perioperative outcomes were collected and assessed, and overall survival and disease-free survival were analyzed.

Results

All procedures were completed successfully with no conversions to open surgery. The median operative time was 240 min, and the median blood loss was 100 mL. The median number of harvested lymph nodes was 29, the median number of harvested thoracic lymph nodes was 18, and of harvested abdominal nodes was 10. The 30-day mortality rate was 0.27% and complications occurred in 133 (35.4%) patients. The median follow-up period was 19 (1–60) months, and 244 patients completed more than 1 year of follow-up. The 1-year overall survival and disease-free survival were 79.5% and 73.8%, respectively.

Conclusion

The modified McKeown MIE is safe and feasible for esophageal cancer, offering satisfactory perioperative outcomes and acceptable oncologic survival.