A Purely Laparoscopic Approach Can Reduce the Incidence of Postoperative Pneumonia in Esophageal Cancer Patients Undergoing Esophagectomy

Overview

Journal Esophagus

Publisher Springer

Date 2025 Feb 10

PMID 39928257

Authors

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

Affiliations

Soon will be listed here.

Abstract

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.

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