Cardiorespiratory Impact of Transesophageal Endoscopic Mediastinoscopy Compared With Cervical Mediastinoscopy

Navarro-Ripoll, Ricard; Córdova, Henry; Rodríguez-D’Jesús, Antonio; Boada, Marc; Miguel, Cristina Rodríguez de; Beltrán, Mireia; Cubas, Georgina; Perdomo, Juan; Llach, Josep; Balust, Jaume; Gimferrer, Josep María; Fernández‐Esparrach, Glòria; Martínez-Pallí, Graciela

doi:10.1177/1553350613517943

Cited by 10 publications

(9 citation statements)

References 19 publications

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“…Inadvertent high pressure pneumomediastinum and pneumothorax have been major adverse events reported since the introduction of thoracic NOTES 2 5 6 8 9 . This event can be explained by the characteristics of the endoscopic access technique, which includes the dissection of the connective tissue located in the pretracheal space.…”

Section: Discussionmentioning

confidence: 99%

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Adverse events of NOTES mediastinoscopy compared to conventional video-assisted mediastinoscopy: a randomized survival study in a porcine model

et al. 2015

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Background: Safety is a concern in natural orifice transluminal endoscopic surgery (NOTES) mediastinoscopy. The objective of this study was to compare the safety of NOTES mediastinoscopy with video-assisted mediastinoscopy (VAM). Methods: Twenty-four pigs were randomly assigned to NOTES or VAM. Thirty-minute mediastinoscopies were performed with the identification of seven predetermined structures. The animals were euthanized after 7 days and necropsy was performed. Results: Mediastinoscopy was not possible in one animal in each group. There were more intraoperative adverse events with NOTES than VAM (7 vs. 2, P = 0.04); hemorrhage was the most frequent adverse event (4 and 1, respectively). At necropsy, pathological findings were observed in 13 animals (9 NOTES and 4 VAM; P = 0.03). Inflammatory parameters were not different between groups and were not related to adverse events. Conclusion: Systematic NOTES mediastinoscopy is possible and comparable to VAM in terms of number of organs identified and inflammatory impact. However, the safety profile of NOTES mediastinoscopy has to be improved before it can be adopted in a clinical setting.

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Section: Discussionmentioning

confidence: 99%

“…This is probably due to a valve effect and requires immediate drainage. However, close monitoring of both hemodynamic and respiratory parameters allows early detection and treatment of pneumothorax and prevents the subsequent fatal outcome 9 .…”

Section: Discussionmentioning

confidence: 99%

Adverse events of NOTES mediastinoscopy compared to conventional video-assisted mediastinoscopy: a randomized survival study in a porcine model

et al. 2015

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“…9 However, CO 2 insufflation into the mediastinum may also lead to hemodynamic instability and therefore add potential risks to cardiopulmonary complications. 5 …”

Section: Commentsmentioning

confidence: 99%

Advancing Gastroscope From Intraluminal to Extraluminal Dissection: Primary Experience of Laparo-gastroscopic Esophagectomy

Shen

Zhang

et al. 2021

Annals of Surgery

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Transhiatal esophagectomy facilitates esophageal resection without the need for thoracotomy. However, this procedure carries the risks of blind and blunt dissection within the mediastinum. More recently, video-assisted or mediastinoscopic transhiatal esophagectomy was introduced to mobilize the esophagus under direct visualization. Even though, the procedure is technically demanding and animal studies have shown that the CO 2 pneumomediastinum may be associated with hemodynamic instability. By further developing already established techniques, we pioneered the transhiatal esophageal mobilization by using hybrid gastroscope (Fig. 1 ). Laparo-gastroscopic esophagectomy, which integrates gastroscope and laparoscope for esophageal mobilization, was successfully implemented on an esophageal cancer patient with a history of lung cancer surgery. The operative duration was 240 minutes with an estimated blood loss of 110 mL. The patient experienced an uneventful recovery and was discharged on postoperative day 9. Further studies will be required to confirm the surgical and oncological efficacy of this innovation.

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“…However, clinical utility has to be weighed against this approach which is rather aggressive compared to endoscopic biopsy and EUS-FNA. Submucosal tunneling allows direct endoscopic examination of mediastinum and the peritoneal cavity, similarly to mediastinoscopy and diagnostic laparoscopy, as shown mostly in animals [68,69]. However, appropriate clinical application will not be commensurate with the technological feasibility.…”

Section: Tunneling For Endoscopic Submucosal Dissection (Esd)mentioning

confidence: 99%

From POEM to POET: Applications and perspectives for submucosal tunnel endoscopy

2016

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Recent advances in submucosal endoscopy have unlocked a new horizon for potential development in diagnostic and therapeutic endoscopy. Increasing evidence has demonstrated that peroral endoscopic myotomy (POEM) is not only clinically feasible and safe, but also has excellent results in symptomatic relief of achalasia. The success of submucosal endoscopy in performance of tumor resection has confirmed the potential of this new area in diagnostic and therapeutic endoscopy. This article reviews the current applications and evidence, from POEM to peroral endoscopic tunnel resection (POET), while exploring the possible future clinical applications in this field.

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Cardiorespiratory Impact of Transesophageal Endoscopic Mediastinoscopy Compared With Cervical Mediastinoscopy

Cited by 10 publications

References 19 publications

Adverse events of NOTES mediastinoscopy compared to conventional video-assisted mediastinoscopy: a randomized survival study in a porcine model

Adverse events of NOTES mediastinoscopy compared to conventional video-assisted mediastinoscopy: a randomized survival study in a porcine model

Advancing Gastroscope From Intraluminal to Extraluminal Dissection: Primary Experience of Laparo-gastroscopic Esophagectomy

From POEM to POET: Applications and perspectives for submucosal tunnel endoscopy

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