Publication:

A study to assess post operative complications of hybrid approach with video assisted thoracoscopic surgery in locally advanced carcinoma oesophagus

Background Despite improvement in the overall survival of patients with carcinoma oesophagus, the morbidity caused by therapeutic interventions is high. The thoracic incision contributes the most to the morbidity with higher pulmonary complications. The minimally invasive and hybrid procedures reduce post-operative morbidities and have similar oncological outcomes compared to open procedures.

Methods Forty patients were included in the study for a period of two years. The objective of this study was to assess the feasibility of a hybrid procedure of VATS oesophagectomy, and laparotomy for the creation of conduit and cervical anastomosis. The patient demographics, tumour characteristics, and intra-operative and post-operative outcomes were analysed.

Results The overall post-operative morbidity was seen in 35% of the patients. Pulmonary complications were noted in 22% of the patients. Oesophagogastric anastomotic leak was seen in two (5%) patients. Mortality was seen in two patients.

Conclusions A minimally invasive approach has been shown to significantly reduce post-operative morbidity. The pulmonary and cardiac complications that are responsible for morbidity and mortality in oesophageal surgeries are significantly lower with minimally invasive and hybrid procedures.