Survival following video-assisted thoracoscopic versus open esophagectomy for esophageal carcinoma

Purpose: This study aimed to compare the overall and disease-free survival of patients who under-went video-assisted thoracoscopic esophagectomy (VATE) or open esophagectomy for esophageal carcinoma. Methods: Patients who underwent radical esophagectomy via VATE (VATE group, N=89) for esophageal carcinoma between January 2008 and De-cember 2012 were retrospectively enrolled in this study. Patients subjected to open radical esophagectomy (open group) were retrospectively included at a ratio of 1:1, matching the VATE group in sex, age, clinical TNM stage, location of the primary tumor and ASA (American Society of Anesthesiologists) score. Results: All the video-assisted thoraco-scopic procedures were successfully completed, without conversion to open procedure. The age, gender, clinical TNM stage, location of the primary tumor and ASA score were similar in the two groups. VATE group was associated with significantly less blood loss and shorter hospital stay. The operative morbidity and mortality were similar between the two groups. The quality of the specimens in terms of resection margin and the number of lymph nodes examined were not inferior in the VATE group. With the median follow-up of 52 months, the 5-year overall survival and disease free survival were similar between the two groups. The operative approach was not an independent prognostic factor in the overall and disease free survival in univariate and multivariate analysis. Conclusions: VATE for esophageal carcinoma is associated with more favorable short-term outcomes and comparable long-term prognosis when compared with open esophagectomy.