Minimally Invasive Ivor Lewis Esophagectomy (MILE): technique and outcomes of 100 consecutive cases

Surg Endosc. 2020 Jul;34(7):3243-3255. doi: 10.1007/s00464-020-07529-0. Epub 2020 Apr 6.

Abstract

Background: Esophagectomy is the mainstay of therapy for esophageal cancer but is a complex operation that is associated with significantly high morbidity and mortality rates. The primary aim of this study is to report our perioperative outcomes, and long-term survival of Minimally Invasive Ivor Lewis Esophagectomy (MILE).

Methods: IRB approved retrospective study of 100 consecutive patients who underwent elective MILE from September 2013 to November 2017 at University of Florida, Jacksonville.

Results: Primary diagnosis was esophageal cancer (n = 96) and benign esophageal disease (n = 4). Anastomotic leak rate was observed in 6%; 30- and 90-day mortality rates were 2% and 3%, respectively. The mean length of hospital stay was 10.3 days; 87 patients were discharged to home, while 12 patients were discharged to rehabilitation facility, and there was one in-hospital mortality secondary to graft necrosis. At a mean follow-up was 37 months (2-74), the 3- and 5-year overall survivals are 63.9 ± 5.0% (95% CI 53.3-72.7%) and 60.5 ± 5.3% (95% CI 49.4-69.9%), respectively. The 3- and 5-year disease-free survival is 75.0 ± 4.8% (95% CI 64.2-83.0%) and 70.4 ± 5.5% (95% CI 58.0-80.0%).

Conclusion: MILE can be performed with low perioperative mortality, and favorable long-term overall and disease-free survival.

Keywords: Esophagectomy; Ivor lewis; MIE; MILE; Minimally invasive.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Anastomosis, Surgical / methods
  • Anastomosis, Surgical / mortality
  • Anastomotic Leak / etiology
  • Anastomotic Leak / mortality
  • Disease-Free Survival
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / methods
  • Esophagectomy / mortality*
  • Female
  • Hospital Mortality
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Minimally Invasive Surgical Procedures / mortality
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality*
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome