A PROSPECTIVE OBSERVATIONAL STUDY ON MANAGEMENT OF ESOPHAGEAL CARCINOMA WITH MINIMALLY INVASIVE IVOR-LEWIS ESOPHAGECTOMY AND ITS OUTCOMES IN A TERTIARY CARE CENTRE IN CENTRAL INDIA
Authors: Dr. Kartik Sharma*, Dr. Harshil Rohit, Dr. Umesh R. Gaikwad, Dr. Nikita Monteiro, Dr. Vaibhav Pandhare
Publication Date: 2026/09/15
DOI: 10.59551/DOI: 10.59551/IJHMP/25832069/2026.7.2.150
Abstract
<p>Introduction: Esophageal cancer is a life threatening malignancy with abysmal survival, even for subjects under therapeutic care. Minimally invasive surgery like minimally invasive Ivor Lewis esophagectomy, which is commonly performed for treating esophageal cancer, has a favourable impact in perioperative morbidity and enhances short term recovery compared to traditional open surgery through thoracotomy. The present study was performed to evaluate the outcomes and complications of minimally invasive Ivor-Lewis esophagectomy (MILE) for esophageal cancer.</p>
<p>Methods and Materials: A prospective observational study of 20 patients, with histologically proven adenocarcinoma of lower esophagus and posted for minimally invasive Ivor-Lewis esophagectomy, was performed in Department of General Surgery of Government Medical College and Hospital, Nagpur for a period of 18 months (From August 2022 to January 2024).</p>
<p>Results: In this study, predominantly patients were females (60%) in the age group of 61 – 70 years, with a mean age of 64.04 ± 5.15 years. All patients experienced dysphagia (100%), and more than half also reported weight loss, odynophagia, and retrosternal pain. Approximately 40 % of patients were diabetic. Additionally, 60% of patients had hypertension, with 20% of those also having diabetes. Around half of patients were smokers (50%). Patients predominantly classified as ASA status II (60%), while the remaining 40% were classified as ASA status III. Predominantly, 60% of patients were classified under the T3 category, while the majority were classified under the N1 category (80%). Majority of patients had duration of surgery 4-5 hours (40%) with mean duration was 4.5 ± 1.72 hours. Among all patients, 40% experienced bleeding in the range of 151 to 200 mL, with a mean blood loss of 176.8 ± 40.07 mL. Among patients with complications, 10% experienced early postoperative bleeding, chyle leak, anastomotic leak, or conduit necrosis, while 60% had no complications. The most common length of stay was 6 days, experienced by 40% of patients, with a mean duration of 6.6 ± 0.97 days. Around 30% patients did not survive, while the remaining 70% survived.</p>
<p>Conclusion: The study demonstrates that minimally invasive Ivor-Lewis esophagectomy (MILE) for esophageal cancer is both safe and effective. The procedure is associated with low mortality rates, short operation times, and brief hospital stays. The most common comorbidities among patients were diabetes and hypertension, which highlights the need for careful management of these conditions to optimize surgical outcomes. In evaluating the complications of MILE, it was found that early postoperative complications were relatively infrequent, with the majority of patients experiencing no complications.</p>
<p>KEYWORDS: Esophageal Cancer, Minimally Invasive Esophagectomy, Ivor Lewis Esophagectomy.</p>
References
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