Background of Lymph Node Dissection for Squamous Cell Carcinoma of the Esophagus

Akiyama, Hiroshi; Takahashi, Masahīko; Y, Ono; Udagawa, Harushi; Kajiyama, Yoshiaki

doi:10.1007/978-4-431-68198-4_2

Cited by 16 publications

(10 citation statements)

References 13 publications

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“…Based on information gathered in Japan about the frequency of lymph node metastases according to tumor location [ 9 ] and the evidence obtained by randomized controlled trials (RCT) such as the HIVEX trial [ 10 ], middle and upper esophageal cancers may be approached by a three-stage thoracoscopy with total mediastinal lymphadenectomy (LN) and laparoscopy with cervical anastomosis after neoadjuvant therapy. In cases of lower esophageal and GEJ, Siewert 1 and 2, a three-stage or a two-stage Ivor Lewis operation is performed, by laparoscopy and thoracoscopy with standard LN with intrathoracic anastomosis after neoadjuvant therapy [ 11 ].…”

Section: The Choice Of the Extension For Mie Esophageal Resection Andmentioning

confidence: 99%

Video-assisted thoracoscopic esophagectomy: keynote lecture

Cuesta

Wielen

Straatman

et al. 2016

Gen Thorac Cardiovasc Surg

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Minimally invasive esophagectomy (MIE) by thoracoscopy after neoadjuvant therapy results in significant short-term advantages such as a lower incidence of pulmonary infections and a better quality of life (QoL) with the same completeness of resection. After 1 year, a better QoL is still observed for MIE in comparison with the open approach, while having the same survival. Seven issues about implementation of MIE for cancer require discussion: (1) choice of the extension of esophageal resection and use of neoadjuvant therapy; (2) reasons to approach the esophageal cancer by MIE; (3) determining the best minimally invasive approach for gastro-esophageal junction cancers; (4) implementation of evidence-based MIE; (5) standardization of the surgical anatomy of the esophagus based on MIE; (6) future lines of research of MIE; and (7) learning process. In the time of imaging-integrated surgery it is clear that the MIE approach should be increasingly implemented in all centers worldwide having an adequate volume of patients and expertise.

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Section: The Choice Of the Extension For Mie Esophageal Resection Andmentioning

confidence: 99%

Video-assisted thoracoscopic esophagectomy: keynote lecture

Cuesta

Wielen

Straatman

et al. 2016

Gen Thorac Cardiovasc Surg

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“…When segment resection is necessary for the treatment of esophageal diseases, resection and reconstruction are the consecutive steps of the operative plan. Surgical guidelines provide clear instructions regarding the resection part of the procedure, and the operative technique is not really challenging for experienced surgeons 9 . However, concerning reconstruction, the literature offers various choices on how to restore the continuity of the alimentary tract.…”

Section: Discussionmentioning

confidence: 99%

Esophageal replacement using cryopreserved tracheal graft

Juhasz¹,

Szilágyi

Miko

et al. 2008

Diseases of the Esophagus

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Esophageal replacement using artificial material is not a new concept. Prior experiences with prostheses, allografts and composite grafts have not proved particularly successful. The aim of this study is to investigate whether cryopreserved animal trachea is suitable for the replacement of the esophagus. In 12 beagle dogs a 6-cm-long segment of the cervical esophagus was removed, and was replaced with cryopreserved trachea, which had been stored for 21 days on -86 degrees C. The proximal and distal ends of the esophagus were joined together with the graft by simple continuous suture (Biosyn 3/0) and covered with the sternohyoid flap. Postoperatively 16 hematological parameters were measured. The dogs were planned to be euthanized at random on days 28, 42 and 56 after the operation. Tests for air leak were performed and the inner diameter of the graft was measured to detect shrinkage. The microscopic structure of the graft was analyzed using haematoxylin and eosin staining. There was no indication of insufficiency. Based on the air leak test the sutures withheld properly. The inner diameter of the graft narrowed from an average 19 mm (+/- 1 mm) to 15.8 mm (+/- 0.6 mm). In length, the graft shortened from an average 60 mm to 47 mm (+/- 3 mm). No feeding difficulty was observed. In two cases wound suppuration was found involving only the cutaneous and subcutaneous layers. Concerning the laboratory parameters, only the fibrinogen level and white blood cell count showed temporary although significant changes. Histology findings on the 56th day showed absolute integration of the trachea with the esophagus, with disintegration of the tracheal cartilages. Cryopreserved trachea seems to be suitable for the replacement of a 5-6-cm-long esophageal segment.

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“…Bei zervikalem Tumorsitz gehören hierzu die Skalenuslymphknoten, Lymphknoten entlang der V. jugularis interna, unmittelbar periösophage- I III I I I I II II Primärtumor II III III I I I I II III I Primärtumor III III III a b Abb. 1 …”

Section: Tnm-klassifikation (N-kategorie)unclassified

Lymphadenektomie bei Tumoren des oberen Gastrointestinaltraktes

Schuhmacher

Novotny

Ott

et al. 2007

Chirurg

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In surgical therapy for upper gastrointestinal cancer, adequate lymphadenectomy together with R0 resection of the primary tumour is one of the most important prognostic factors which can be influenced by the surgeon. Recommendations for localization- and stage-adapted lymphadenectomy can be made according to histopathologic and anatomic investigations of the patient collectives of large centres. After neoadjuvant radiochemotherapy in cancer of the cervical oesophagus, the absence of lymph nodes on the resected specimen seems to be of less prognostic value. In squamous cell cancer of the suprabifurcal oesophagus, radical lymphadenectomy is recommended. Despite significant morbidity, in specialized centres this procedure yields good results with low mortality. For infrabifurcal oesophageal cancer, two-field lymphadenectomy during the so-called Ivor-Lewis operation is the method of choice. Locally advanced Barrett carcinoma is also an indication for classic two-field lymphadenectomy together with abdominothoracic oesophagectomy and creation of a stomach tube with intrathoracic anastomosis. The lymphadenectomy should however include the area of retroperitoneal lymphatic drainage at the pedicle of the left kidney. Submucosal cancer in this area can be treated with luminal limited resection of the oesophagogastric junction with adequate lymphadenectomy. Adenocarcinoma of the cardia and subcardial gastric cancer including the cardia both require lymphadenectomy analogous to that performed in gastric cancer, with special attention paid to the retroperitoneal lymphatic drainage towards the left kidney pedicle. For therapy of gastric cancer, a systematic D2 lymphadenectomy should always be performed.

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Background of Lymph Node Dissection for Squamous Cell Carcinoma of the Esophagus

Cited by 16 publications

References 13 publications

Video-assisted thoracoscopic esophagectomy: keynote lecture

Video-assisted thoracoscopic esophagectomy: keynote lecture

Esophageal replacement using cryopreserved tracheal graft

Lymphadenektomie bei Tumoren des oberen Gastrointestinaltraktes

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