Laparoscopy-assisted surgery: A new technique for transhiatal esophageal dissection

Sadanaga, Noriaki; Kuwano, Hiroyuki; Watanabe, Masayuki; Inamori, Masahiko; Mori, Masaki; Maekawa, Soichiro; Hashizume, Makoto; Kitano, Seigo; Sugimachi, Keizō

doi:10.1016/s0002-9610(05)80165-5

Cited by 45 publications

(27 citation statements)

References 8 publications

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“…Videoscopy has been used in THE performed via the neck [6][7][8] and hiatus [2,27] and in conjunction with laparoscopy [11,29]. However, videoscopy via the hiatus and the laparoscopic approach are inadequate for surgical treatment of squamous cell carcinoma because the upper mediastinal structures where lymph node metastases are common cannot be reached.…”

Section: Discussionmentioning

confidence: 99%

Mediastinoscope-assisted transhiatal esophagectomy for esophageal cancer

et al. 2004

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Section: Discussionmentioning

confidence: 99%

Mediastinoscope-assisted transhiatal esophagectomy for esophageal cancer

et al. 2004

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“…In order to avoid these problems, new surgical techniques were developed [7,9,10]. Laparoscopically assisted transhiatal esophagectomy was first described by Sadanaga et al [8]. The authors believed that this technique enables the surgeon to avoid the disadvantages attributed to 'blind' esophagectomy and prevents the above mentioned intra-and postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

“…VTE was performed through an upper midline laparotomy. The surgical procedure was similar to that described by Sadanaga et al [8]. Laparoscopic instruments (Olympus Optical Co., Tokyo, Japan) and the harmonic knife (AutoSonix System, Tyco Healthcare, Mansfield, MA, USA) were used for dissecting the esophagus and lymph nodes ( fig.…”

Section: Methodsmentioning

confidence: 99%

“…A better visualization of the esophagus and mediastinal structures during transhiatal esophagectomy can be obtained by diaphragmatic incision [5,6] or by the use of an endodissector [7], a laparoscope [8,9] or a thoracoscope [10]. In preliminary reports [8,9] video/laparoscopy-assisted transhiatal esophagectomy is recommended as a technique which may prevent various intra-and postoperative complications. The aim of this study was to evaluate the clinical safety and usefulness of laparoscopically assisted transhiatal esophagectomy for esophageal cancer.…”

Section: Introductionmentioning

confidence: 99%

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Complications following Video-Assisted Transhiatal Esophagectomy for Esophageal Cancer

Lampe¹,

Wojtyczka²,

Lekstan³

et al. 2005

Visc Med

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Background: The aim of the study was to evaluate the clinical safety and usefulness of esophageal dissection under laparoscopic monitoring during transhiatal esophagectomy for esophageal cancer. Patients and Methods: The study group of 115 patients included 102 men and 13 women. The mean age was 57 (range 32-79) years. Tumor histology showed a squamous cell carcinoma in 75% and an adenocarcinoma in 25% of cases. According to the American Joint Committee on Cancer classification, 3 patients were classified as stage I, 19 as stage IIA, 24 as stage IIB, 64 as stage III, and 5 as stage IVA. Mean operating time was 4.5 ± 1 h. Results: Ten significant intraoperative complications were observed (9 hemorrhages, 1 death). The mean blood loss was 900 (range 300-2,100) ml. Postoperative complications occurred in 61% of the patients; the most frequent were pulmonary complications (27%), recurrent laryngeal nerve injury (17.4%), anastomotic stricture (14%), and anastomotic leak (10.4%). Early re-laparotomy was performed in 6% of the patients. Hospital mortality rate was 9%. Mean hospital stay was 34 (range 5-64) days. Conclusion: Video-assisted transhiatal esophagectomy is a useful method, but does not allow a vision-guided removal of the upper esophagus. The method does not prevent or diminish the number of intra- and postoperative complications of esophageal resection.

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“…Notably, blind and frequent blunt manual dissection of the esophagus may result in cardiopulmonary complications [16]. The minimally invasive approach for esophagus dissection and resection enables a perfect view of the esophagus and the tumor up to the carina, and the dissection can be done in an avascular plane through anatomic layers under direct vision of the laparoscope [11]. A major disadvantage of this technique may be the pleura perforation, or the necessity to resect a part of the pleura as a part of the mediastinal resection of the tumor, which can be hazardous.…”

Section: Discussionmentioning

confidence: 99%