Laparoscopic transhiatal esophagectomy for esophageal cancer

Avital, Shmuel; Zundel, Natán; Szomstein, Samuel; Rosenthal, Raúl J.

doi:10.1016/j.amjsurg.2004.12.004

Cited by 58 publications

(50 citation statements)

References 16 publications

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“…Many approaches have been described using thoracoscopy and laparoscopy or the combination of a minimally invasive approach with an open procedure (i.e., thoracoscopy with laparotomy and cervical incision). The true MIE technique, however, includes laparoscopy and thoracoscopy for MIE Ivor Lewis esophagectomy [15,16]; thoracoscopy, laparoscopy, and cervical incision for MIE three-incision esophagectomy [17,18]; and laparoscopy with cervical incision for MIE THE [19,20]. Modern technology has allowed the completion of such complex procedures by minimally invasive surgery.…”

Section: Minimally Invasive Esophagectomymentioning

confidence: 99%

“…The guide is then removed and the anvil is connected to the circular stapler handle to allow for the creation of a doubled stapled anastomosis. Finally, ligation and division of small vessels such as the left gastroepiploic and short gastric arteries are easily facilitated by either the endoscopic ultrasonic coagulating shears [17][18][19] or the endoscopic pressure-energy tissue sealing device [20].…”

Section: Minimally Invasive Esophagectomymentioning

confidence: 99%

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Advances in the surgical treatment of esophageal cancer

Vezeridis

2010

Journal of Surgical Oncology

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Surgical resection remains the predominant modality in the management of esophageal cancer. Transthoracic and transhiatal esophagectomy are the procedures that are most frequently performed. Minimally invasive esophagectomy is feasible but will require further evaluation with well-designed trials and long-term follow-up before it can be widely adopted. Technical improvements have lowered the rate of cervical anastomotic leak and improved the management of thoracic anastomotic leak. Outcome studies demonstrated that the optimal mortality, morbidity, and survival outcomes are obtained when esophageal resections are performed by experienced surgeons in high-volume institutions.

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Section: Minimally Invasive Esophagectomymentioning

confidence: 99%

Section: Minimally Invasive Esophagectomymentioning

confidence: 99%

Advances in the surgical treatment of esophageal cancer

Vezeridis

2010

Journal of Surgical Oncology

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“…The average operative time was 380 minutes and 4.5% developed leaks. 5 In the second trial, 20 patients underwent laparoscopic transhiatal esophagectomy, including 2 conversions to open procedures. Median operative time in this series was 415 minutes.…”

Section: Commentmentioning

confidence: 99%

Simplifying Minimally Invasive Transhiatal Esophagectomy With the Inversion Approach

et al. 2006

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The laparoscopic transhiatal esophagectomy can be simplified and performed safely and effectively by using a novel esophageal inversion technique.Design: Case series describing technique, initial experience, and learning curve with laparoscopic inversion esophagectomy.Setting: Tertiary care university hospital and veteran's hospital.Patients: Twenty consecutive patients with highgrade dysplasia (n = 16) and esophageal adenocarcinoma (n=4).Intervention: Laparoscopic inversion esophagectomy, a totally laparoscopic approach to transhiatal esophagectomy that incorporates distal to proximal inversion to improve mediastinal exposure and ease of dissection.Main Outcome Measures: Perioperative end points and complications, compared between the first and second groups of 10 patients.Results: There were 19 men and 1 woman. Median operative time was 448 minutes. Median blood loss was 175 cm 3 . Median intensive care unit stay was 4 days, and median total hospital stay was 9 days. Overall anastomotic leak rate was 20%. Five patients developed an anastomotic stricture, all successfully managed with endoscopic dilation. There were 2 recurrent laryngeal nerve injuries, which resolved. There was no intraoperative or 30-day mortality. Between the first 10 consecutive cases and last 10 procedures, the incidence of anastomotic leak and stricture formation decreased from 30% to 10% and 40% to 10%, respectively. During this period, the number of lymph nodes harvested increased 9-fold, and duration of intensive care unit stay decreased from 8.00 to 2.50 days.Conclusions: Laparoscopic inversion esophagectomy is a safe procedure. The learning curve for the inversion approach is approximately 10 operations in the hands of esophageal surgeons with advanced laparoscopic expertise.

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“…Luketich et al [11] reported a rate of permanent injury of 3.6%. Other authors have reported a permanent rate of 2% [12] and 5% [13]. However, the median rate of injury, including temporary, in published series is 10%, with a range between 5% and 24% [3,5,6,[14][15][16][17].…”

Section: Discussionmentioning

confidence: 94%