I. Lewis minimally invasive esophagectomy


  • G. Yu. Savenko SI “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0002-8454-1992
  • O. Ye. Sydiuk SI “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0001-8522-7121




esophagectomy, esophageal diseases


The aim of the study was to improve the direct results of surgical treatment for esophageal diseases by implementing the method of minimally invasive esophagectomy according to I. Lewis.

Materials and methods. A total of 92 patients with esophageal diseases were divided into 2 groups: mini-invasive esophagectomy (MIE) and open esophagectomy (OE). The groups were comparable in age, sex, comorbidity and the stage of a disease (P > 0.05).

Results. The duration of OE was 270 minutes (IQR 257.5–320.0 minutes), and it was statistically significantly (P < 0.001) less than the duration of MIE – 350 minutes (IQR 326.25–387.50 minutes). The volume of intraoperative blood loss in OE was 400 ml (IQR 300–500 ml) that was statistically significantly (P < 0.001) higher than in MIE – 130 ml (IQR 90–165 ml). The mean value of blood transfusion volume for patients with OE was 283 ml (IQR 261.25–468.50), which was statistically significantly higher (P < 0.001) than in MIE group – 0 (IQR 0.00–246.75). The length of intensive care unit stay in patients after OE was 4 days (IQR 3.00–5.25), in contrast to 2 days in MIE group (IQR 1.00–2.00), P < 0.001. The postoperative period of treatment for patients after OE averaged 12 days (IQR 10.00–15.25), after MIE – 8 days (IQR 8.00–11.00), P < 0.001.

Conclusions. Based on the experience of using minimally invasive esophagectomy according to I. Lewis, the safety, efficacy and advantages of the surgical intervention over open esophagectomy have been demonstrated.

Author Biographies

G. Yu. Savenko, SI “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, Kyiv

MD, Surgeon, Junior Researcher of the Department of Thoracoabdominal Surgery

O. Ye. Sydiuk, SI “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, Kyiv

MD, PhD, Senior Researcher, Head of the Department of Intensive Care and Anaesthesiology


van der Sluis, P. C., Schizas, D., Liakakos, T., & van Hillegersberg, R. (2020). Minimally Invasive Esophagectomy. Digestive Surgery, 37(2), 93-100. https://doi.org/10.1159/000497456

Wullstein, C., Ro-Papanikolaou, H. Y., Klingebiel, C., Ersahin, K., & Carolus, R. (2015). Minimally Invasive Techniques and Hybrid Operations for Esophageal Cancer. Viszeralmedizin, 31(5), 331-336. https://doi.org/10.1159/000438661

van Hillegersberg, R., Boone, J., Draaisma, W. A., Broeders, I. A., Giezeman, M. J., & Borel Rinkes, I. H. (2006). First experience with robot-assisted thoracoscopic esophagolymphadenectomy for esophageal cancer. Surgical Endoscopy And Other Interventional Techniques, 20(9), 1435-1439. https://doi.org/10.1007/s00464-005-0674-8

Mann, C., Berlth, F., Hadzijusufovic, E., Lang, H., & Grimminger, P. P. (2020). Minimally invasive esophagectomy: clinical evidence and surgical techniques. Langenbeck's Archives of Surgery, 405(8), 1061-1067. https://doi.org/10.1007/s00423-020-02003-w

Watkins, A. A., Kent, M. S., & Wilson, J. L. (2020). Surgical Adjuncts During Esophagectomy. Thoracic Surgery Clinics, 30(3), 315-320. https://doi.org/10.1016/j.thorsurg.2020.04.009

Achim, F., & Constantinoiu, S. (2018). Recent Advances in Minimally Invasive Esophagectomy. Chirurgia, 113(1), 19-37. https://doi.org/10.21614/chirurgia.113.1.19

Markar, S. R., Ni, M., Gisbertz, S. S., van der Werf, L., Straatman, J., van der Peet, D., Cuesta, M. A., Hanna, G. B., van Berge Henegouwen, M. I., & Dutch Upper GI Cancer Audit and TIME Study Group. (2020). Implementation of Minimally Invasive Esophagectomy From a Randomized Controlled Trial Setting to National Practice. Journal of Clinical Oncology, 38(19), 2130-2139. https://doi.org/10.1200/JCO.19.02483

Wijnhoven, B., & Lagarde, S. M. (2021). Minimally Invasive Esophagectomy: Time to Reflect on Contemporary Outcomes. Journal of Clinical Oncology, 39(1), 90-91. https://doi.org/10.1200/JCO.20.01620

Wang, Q., Wu, Z., Zhan, T., Fang, S., Zhang, S., Shen, G., & Wu, M. (2019). Comparison of minimally invasive Ivor Lewis esophagectomy and left transthoracic esophagectomy in esophageal squamous cell carcinoma patients: a propensity score-matched analysis. BMC Cancer, 19(1), Article 500. https://doi.org/10.1186/s12885-019-5656-7

Tapias, L. F., Mathisen, D. J., Wright, C. D., Wain, J. C., Gaissert, H. A., Muniappan, A., Lanuti, M., Donahue, D. M., & Morse, C. R. (2016). Outcomes With Open and Minimally Invasive Ivor Lewis Esophagectomy After Neoadjuvant Therapy. The Annals of Thoracic Surgery, 101(3), 1097-1103. https://doi.org/10.1016/j.athoracsur.2015.09.062

Lv, L., Hu, W., Ren, Y., & Wei, X. (2016). Minimally invasive esophagectomy versus open esophagectomy for esophageal cancer: a meta-analysis. OncoTargets and Therapy, 9, 6751-6762. https://doi.org/10.2147/OTT.S112105

Yibulayin, W., Abulizi, S., Lv, H., & Sun, W. (2016). Minimally invasive oesophagectomy versus open esophagectomy for resectable esophageal cancer: a meta-analysis. World Journal of Surgical Oncology, 14(1), Article 304. https://doi.org/10.1186/s12957-016-1062-7

Klevebro, F., Scandavini, C. M., Kamiya, S., Nilsson, M., Lundell, L., & Rouvelas, I. (2018). Single center consecutive series cohort study of minimally invasive versus open resection for cancer in the esophagus or gastroesophageal junction. Diseases of the Esophagus, 31(10), 1-6. https://doi.org/10.1093/dote/doy027



How to Cite

Savenko GY, Sydiuk OY. I. Lewis minimally invasive esophagectomy. Zaporozhye Med J [Internet]. 2022May30 [cited 2023Dec.5];24(3):317-21. Available from: http://zmj.zsmu.edu.ua/article/view/251586



Original research