Standardized Approach to Ivor Lewis Esophagectomy Demonstrates Low Morbidity and Mortality Rates

Strategic Insights -

Research published in the Journal of Gastrointestinal Surgery has investigated the effectiveness of a standardized approach to Ivor Lewis esophagectomy, a surgical procedure for treating esophageal cancer. The study, conducted by investigators at Thomas Jefferson University, involved a retrospective review of 145 patients who underwent the procedure between 2017 and 2023. The researchers found that a standardized approach to perioperative management and operative technique resulted in low morbidity and mortality rates, even when transitioning to a robotic-assisted technique.

Key Takeaways:

  • The study included 145 patients who underwent Ivor Lewis esophagectomy between June 1, 2017, and July 7, 2023.
  • The researchers found that the length of stay ranged from 5 to 84 days, with a median of 7 days.
  • Leak from the esophagogastric anastomosis occurred in 5 cases (3.4%), and pulmonary complications occurred in 21 cases (14.5%).
  • The study demonstrated that a standardized approach to perioperative management and operative technique can facilitate transitioning to a robotic-assisted technique without increasing complications.
  • Patients who underwent robotic-assisted esophagectomy had a mean operative time of 443 minutes, while those who underwent laparoscopic/thoracoscopic esophagectomy had a mean operative time of 387 minutes.
  • The study concluded that a standardized approach to Ivor Lewis esophagectomy can result in low morbidity and mortality rates and facilitate the transition to a robotic-assisted technique.

Statistics:

  • 145 patients were included in the study.
  • The length of stay ranged from 5 to 84 days, with a median of 7 days.
  • Leak from the esophagogastric anastomosis occurred in 5 cases (3.4%).
  • Pulmonary complications occurred in 21 cases (14.5%).
  • The mean operative time for robotic-assisted esophagectomy was 443 minutes (95% CI -88.1 to -34.2).
  • The mean operative time for laparoscopic/thoracoscopic esophagectomy was 387 minutes.

Sources:

  • A Standardized Health System Approach to Ivor Lewis Esophagectomy. Journal of Gastrointestinal Surgery, 2025:102250. Elsevier Science Inc, Ste 800, 230 Park Ave, New York, NY 10169, USA. www.elsevier.com; www.journals.elsevier.com/journal-of-gastrointestinal-surgery/
  • Luke Meredith, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St, Suite 100, Philadelphia, PA, 19107, United States.
  • Additional authors: Peter Yang, Hamza Rshaidat, Scott Koeneman, Darshak Thosani, John Jacob, Tyler Grenda, Olugbenga Okusanya, Francesco Palazzo, Karen A. Chojnacki, Sung Whang, and Nathaniel R. Evans.