Outcomes of open versus minimally invasive oesophagectomy in an Australian quaternary referral centre: a historical case-matched study.

Background: Oesophagectomy for surgical management of oesophageal carcinoma has previously been performed via an open approach (OE), with a change in recent years to a minimally invasive technique (MIO). We performed a retrospective study to compare the rates of post-operative complications between OE and MIO patients at our institution. Secondary outcomes included nodal yield and ICU LOS.

Methods: This is a retrospective, observational, case-matched single centre study of 2-stage oesophagectomies for carcinoma from January 2011 to December 2021. Fourty-four MIO patients were matched by age to 44 OE patients. Post-operative pulmonary, cardiac and surgical complications were defined using the Esophagectomy Complications Consensus Group (ECCG) guidelines.

Results: Baseline characteristics were similar for the two groups, with a higher ASA grade for patients undergoing MIO. There was no significant difference in post-operative pulmonary complication rates between the OE versus MIO groups (41% versus 55%, P = 0.29). There were more cardiac arrhythmias in the MIO group however this was not statistically significant (9.1% versus 22.7%, P = 0.08). Rate of re-operation was equal between the groups with no difference between rates of other surgical complications, ICU LOS or hospital LOS. Significantly higher nodal yield was achieved in the MIO group. Overall rate of Clavien-Dindo graded complications were similar (55% versus 66%, P = 0.28).

Conclusions: MIO was associated with higher lymph node yield, and comparable complication rates when compared to OE and does not significantly alter time spent in hospital.