Abdominal and right thoracotomy approach as standard procedure for esophagogastrectomy with low morbidity

Mitchell, Robert L.

doi:10.1016/s0022-5223(19)36442-6

Cited by 22 publications

(4 citation statements)

References 11 publications

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“…We usually avoided operating on patients with seriously impaired pulmonary, cardiac, or hepatic function, and the criteria that contraindicate oesophageal surgery in our department are as follows: a recent myocardial infarction (within three months), hepatic dysfunction: (Child's grade C or active hepatitis), A performance status of 3 or 4 (12), or severe psychological disturbances. We usually did the oesophagectomy and radical lymph node dissection through a right thoracoabdom- inal approach with a view to resecting the entire malignant lesion (1,5,8) although we did do transhiatal resection without thoracotomy for patients with either pulmonary dysfunction or with early disease. Although about a half of the patients had some preoperative organ dysfunction there was no association between preoperative organ dysfunction and related organ insufficiency or other complications, except for those between preoperative pulmonary function and the development of pulmonary and total complications.…”

Section: Discussionmentioning

confidence: 99%

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Relationship between preoperative assessment of organ function and postoperative morbidity in patients with oesophageal cancer

et al. 2003

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Section: Discussionmentioning

confidence: 99%

“…Recently, both the morbidity and mortality after oesophageal surgery have decreased and most postoperative complications do not lead directly to death (2,5,10). We had six deaths (3%) of complications and, among them three (2%) died within 30 days.…”

Section: Discussionmentioning

confidence: 99%

Relationship between preoperative assessment of organ function and postoperative morbidity in patients with oesophageal cancer

et al. 2003

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“…Even for patients with locally advanced EC, surgery remains a very important component of multi-modality therapy. Currently, many procedures for esophageal resection and reconstruction are available, and Ivor-Lewis esophagectomy combined with two-field lymphadenectomy has become the standard procedure for middle and lower EC[ 2 - 6 ]. Compared with open Ivor-Lewis esophagectomy, minimally invasive laparoscopic-thoracoscopic Ivor-Lewis esophagectomy has an obvious advantage of reducing the incidence of perioperative complications while having similar therapeutic outcomes[ 7 - 16 ].…”

Section: Introductionmentioning

confidence: 99%

Two-step method for creating a gastric tube during laparoscopic-thoracoscopic Ivor-Lewis esophagectomy

Liu

et al. 2017

WJG

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AIMTo introduce a two-step method for creating a gastric tube during laparoscopic-thoracoscopic Ivor-Lewis esophagectomy and assess its clinical application.METHODSOne hundred and twenty-two patients with middle or lower esophageal cancer who underwent laparoscopic-thoracoscopic Ivor-Lewis esophagectomy at Liaoning Cancer Hospital and Institute from March 2014 to March 2016 were included in this study, and divided into two groups based on the procedure used for creating a gastric tube. One group used a two-step method for creating a gastric tube, and the other group used the conventional method. The two groups were compared regarding the operating time, surgical complications, and number of stapler cartridges used.RESULTSThe mean operating time was significantly shorter in the two-step method group than in the conventional method group [238 (179-293) min vs 272 (189-347) min, P < 0.01]. No postoperative death occurred in either group. There was no significant difference in the rate of complications [14 (21.9%) vs 13 (22.4%), P = 0.55] or mean number of stapler cartridges used [5 (4-6) vs 5.2 (5-6), P = 0.007] between the two groups.CONCLUSIONThe two-step method for creating a gastric tube during laparoscopic-thoracoscopic Ivor-Lewis esophagectomy has the advantages of simple operation, minimal damage to the tubular stomach, and reduced use of stapler cartridges.

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“…The conventional operation, in which the esophagus and adjacent lymph nodes are dissected under vision through the right chest with intrathoracic esopha-gogastric anastomosis, is preferred by most surgeons. 1 The procedure of transhiatal (TH) esophagectomy with cervical esophagogastrostomy popularized by Orringer 2 has gained widespread acceptance. It avoids thoracotomy and the esophagectomy performed is subtotal.…”

Section: Introductionmentioning

confidence: 99%

Transhiatal versus Transthoracic Esophagectomy for Distal Esophageal Cancer

Gupta

2000

Asian Cardiovasc Thorac Ann

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From 1982From to 1986 of 34 consecutive patients with squamous cell carcinoma of the distal esophagus had resection by the transthoracic approach. From 1987 to 1990, 39 of 48 consecutive patients underwent transhiatal esophagectomy. The two groups were comparable in terms of demographics, preoperative risk factors, and tumor stage. All patients had received one cycle of anterior chemotherapy. The incidence of pneumonia and wound infection was significantly higher following transthoracic compared to transhiatal resection (44% versus 18%). Transhiatal esophagectomy required markedly less operating time (137 versus 327 min) but had a higher incidence of recurrent laryngeal nerve palsy (20% versus 0%). Anastomotic leaks occurred with similar frequency in both groups (23% versus 19%) and intrathoracic disruption carried a very high mortality (80%). Transhiatal resection had lower mortality (10% versus 26%) and both groups had similar survival. These results suggest that compared to transthoracic esophagectomy, the transhiatal approach had fewer complications, a lower mortality rate, and comparable survival, and thus remains an acceptable procedure for resection of squamous cell carcinoma of the distal esophagus.

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Abdominal and right thoracotomy approach as standard procedure for esophagogastrectomy with low morbidity

Cited by 22 publications

References 11 publications

Relationship between preoperative assessment of organ function and postoperative morbidity in patients with oesophageal cancer

Relationship between preoperative assessment of organ function and postoperative morbidity in patients with oesophageal cancer

Two-step method for creating a gastric tube during laparoscopic-thoracoscopic Ivor-Lewis esophagectomy

Transhiatal versus Transthoracic Esophagectomy for Distal Esophageal Cancer

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