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Background <p>Minimally invasive esophagectomy for esophageal cancer has become increasingly common to reduce postoperative pneumonia. However, the usefulness of pure laparoscopic abdominal manipulation without an upper abdominal incision remains unclear.</p> Methods <p>We evaluated the utility of pure laparoscopic surgery (LAP) vs. hand-assisted laparoscopic surgery (HALS) in esophagectomy. A total of 344 consecutive patients who underwent curative esophagectomy for esophageal cancer from 2019 to 2023 were enrolled; 235 patients were treated with HALS and 109 with LAP. The peri- and postoperative outcomes were compared between the two groups using a propensity score-matched analysis.</p> Results <p>Propensity score matching was used to compare 92 patients each in the HALS and LAP groups. Clinicopathological characteristics did not differ between the two groups. The incidence of postoperative pneumonia was significantly higher in the HALS group than in the LAP group (30% vs. 11%, respectively; P = 0.001). Multivariate logistic analysis showed that HALS was independently associated with postoperative pneumonia (odds ratio 3.82, P = 0.002), along with older age and male sex.</p> Conclusions <p>LAP may reduce the incidence of postoperative pneumonia in esophageal cancer patients who undergo esophagectomy.</p>

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A purely laparoscopic approach can reduce the incidence of postoperative pneumonia in esophageal cancer patients undergoing esophagectomy

  • 期刊论文

  • 发表日期：

    2025年2月10日

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  • Yoshiro Yukawa,
  • Kotaro Yamashita,
  • Kota Momose,
  • Takuro Saito,
  • Koji Tanaka,
  • Tomoki Makino,
  • Kazuyoshi Yamamoto,
  • Tsuyoshi Takahashi,
  • Yukinori Kurokawa,
  • Ryohei Kawabata,
  • Atsushi Takeno,
  • Kiyokazu Nakajima,
  • Hidetoshi Eguchi,
  • Yuichiro Doki

摘要

Background

Minimally invasive esophagectomy for esophageal cancer has become increasingly common to reduce postoperative pneumonia. However, the usefulness of pure laparoscopic abdominal manipulation without an upper abdominal incision remains unclear.

Methods

We evaluated the utility of pure laparoscopic surgery (LAP) vs. hand-assisted laparoscopic surgery (HALS) in esophagectomy. A total of 344 consecutive patients who underwent curative esophagectomy for esophageal cancer from 2019 to 2023 were enrolled; 235 patients were treated with HALS and 109 with LAP. The peri- and postoperative outcomes were compared between the two groups using a propensity score-matched analysis.

Results

Propensity score matching was used to compare 92 patients each in the HALS and LAP groups. Clinicopathological characteristics did not differ between the two groups. The incidence of postoperative pneumonia was significantly higher in the HALS group than in the LAP group (30% vs. 11%, respectively; P = 0.001). Multivariate logistic analysis showed that HALS was independently associated with postoperative pneumonia (odds ratio 3.82, P = 0.002), along with older age and male sex.

Conclusions

LAP may reduce the incidence of postoperative pneumonia in esophageal cancer patients who undergo esophagectomy.