Laparoscopic hand-assisted vs open transhiatal esophagectomy - A case-control study

Background: This case-control study evaluated and compared the outcomes of laparoscopically assisted (LTE) and open transhiatal esophagectomy (OTE). Methods: In this study, 17 patients Who underwent LTE during this period August 1999 through June 2003 were compared with 14 matched control patients who underwent OTE during this period December 1989 through September 2001. The groups had stage I esophageal cancer or lesser disease at the preoperative evaluation. Patients with prior upper abdominal or thoracic surgery were excluded. Results: There was no significant difference between the groups with respect to age, body mass index, American Society of Anesthesiology (ASA) classification, or operating time. The estimated blood loss was 331 (± 220) ml for LTE and 542 (± 212) ml for OTE (p = 0.01). The hospital stay was 9.1 (± 3.2) days for LTE and 11.6 (± 2.9) days for OTE (p = 0.04). Comparing only the last six LTE with the OTE, the operating time was 311 (± 31) min for LTE and 388 (± 14) min for OTE (p = 0.02). Conclusions: The findings showed shorter operative time, less blood loss, and a shorter hospital stay with LTE than with OTE.