Lymphadenectomy along the left recurrent laryngeal nerve by a minimally invasive esophagectomy in the prone position for thoracic esophageal cancer

Noshirο, Hirokazu; Iwasaki, Hiromichi; Kobayashi, Kiitiro; Uchiyama, Akihiko; Miyasaka, Yoshihiro; Masatsugu, Toshihiro; Koike, Kazuo; Miyazaki, Kouji

doi:10.1007/s00464-010-1072-4

Cited by 154 publications

(150 citation statements)

References 29 publications

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“…İleri evre hastalığı olan olgulara ise konvansiyonel cerrahi yapıldı. Servikal anastomozlu torakoskopik özofajektomi işlemi ile ilgili literatür çalışmalarında; ortalama ameliyat süresinin 265-350 dakika arasında olduğu, anastomoz kaçağı riskinin ise ortalama %8 ile %28 arasında değiştiği ortaya konmuştur (10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Ayrıca postoperatif dönemde ortalama yoğun bakımda kalma süresi minimal invaziv özofajektomi yapılan hastalarda 1 gün iken açık cerrahide bu süre 6 güne kadar çıkmaktadır.…”

Section: Discussionunclassified

“…Onkolojik olarak minimal invaziv özofajektomi ile çıkarılan spesmen ve lenf nodları, açık cerrahi ile çıkarılanlarla hemen hemen aynı iken, hastalıksız sağkalım ile toplam sağkalım sonuçları açısından her iki prosedür arasında bir fark bulunamamıştır. Bu çalışmalar, postoperatif solunum komplikasyonlarının azlığı ve hızlı iyileşme süreci gibi avantajları nedeniyle minimal invaziv özofajektomiyi önermektedirler (15)(16)(17)(18). Bizim olgularımızda ise ameliyat süresi ortalama yaklaşık 222 dakika olup literatür ile karşılaştırıldığında daha kısa idi.…”

Section: Discussionunclassified

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Thoracoscopic-Laparoscopic Esophagectomy for Carcinoma of the Esophagus: Preliminary Reports of Seven Cases from the High-Volume Institution

Toktaş¹,

İliklerden²,

Yerlikaya³

et al. 2016

Van Med J

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Section: Discussionunclassified

Thoracoscopic-Laparoscopic Esophagectomy for Carcinoma of the Esophagus: Preliminary Reports of Seven Cases from the High-Volume Institution

Toktaş¹,

İliklerden²,

Yerlikaya³

et al. 2016

Van Med J

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“…Kuwabara and colleagues were also in favor of prone position, because of its superiority in less blood loss, respiratory tract complications, postoperative hospital stay, and number of lymph nodes dissected (7). Another study by Noshiro et al reported prone esophagectomy with significantly less blood loss, but longer operation time (9). Findings of a retrospective analysis of small numbers of patients suggested that hemodynamic parameters remain stable during prone positioning (10).…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic Esophagectomy in Supine Position

Abdollahi

Alipour

Tavassoli

et al. 2015

J Minim Invasive Surg Sci

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Background: Esophageal cancer needs major surgery due to its anatomic position, which is followed by high morbidity in most patients. Thoracotomy, a previously used method, was accompanied by high pulmonary complications, had physical limitations, and low tolerance of patients. Thoracoscopic esophagectomy is a new suitable method with less morbidity. Objectives: The present study aimed to investigate the results of performing three phases of esophagectomy through laparoscopy and thoracoscopy in supine position without frequent changes in patients' position. Patients and Methods: This is a prospective study of 15 selected patients who underwent laparoscopic thoracoscopic esophagectomy and received preoperative radiotherapy between 2010 and 2011. At first, laparoscopic gastrolysis was carried out and then, transhiatal esophageal release was performed (up to the upper region); thereafter the upper esophagus was exposed by thoracoscopy in supine position and easily released. Results: The mean duration of esophagectomy was 70 minutes and the total operation 180 minutes. The mean amount of bleeding during surgery was 250 cc. Conversion to open approach occurred only in one patient out of 15. No cases of anastomotic leakage or pneumonia was observed. Also, no case of mortality was reported. Conclusions: Thoracoscopic esophagectomy can be easily performed in supine position and in a short time. .

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“…and serious complications following esophagectomy (2)(3)(4). It was recently demonstrated that thoracoscopic (15)(16)(17)(18)(19) or mediastinoscopic esophagectomy (20,21) minimizes injury to the chest wall and reduces surgical invasiveness. Furthermore, the duration of one-lung ventilation is known to affect postoperative immune reactions and cause respiratory complications (6,7).…”

Section: Discussionmentioning

confidence: 99%

Middle and lower esophagectomy preceded by hand-assisted laparoscopic transhiatal approach for distal esophageal cancer

Shiozaki

Fujiwara

Konishi

et al. 2013

Molecular and Clinical Oncology

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Abstract. Respiratory morbidity is the most frequent complication following an esophagectomy. This study was designed to determine the efficacy of middle and lower esophagectomies preceded by the hand-assisted laparoscopic transhiatal approach (LTHA) regarding the perioperative outcomes of distal esophageal cancer. The esophageal hiatus was opened and carbon dioxide was introduced into the mediastinum. Dissection of the distal esophagus was performed up to the level of the tracheal bifurcation. En bloc dissection of the posterior mediastinal lymph nodes was performed using the LTHA. Subsequently, a small thoracotomy (10 cm) was performed to divide the thoracic esophagus and allow middle mediastinal lymphadenectomy. Finally, reconstruction via the posterior mediastinal route with a gastric tube and anastomosis in the thoracic cavity were performed using a circular stapler. The treatment outcomes of 10 patients who underwent LTHA-preceded middle and lower esophagectomy were compared to those of 11 patients treated without prior LTHA (thoracotomy, 20 cm). The total operative time, the duration of one-lung ventilation and total operative blood loss were significantly decreased in the LTHA group. The number of resected lymph nodes did not differ significantly between the two groups. Postoperative respiratory complications occurred in 10.0% of patients treated with, and 36.3% of those treated without LTHA. The extubation time following surgery, the duration of thoracic drainage and postoperative hospital stay were significantly decreased by this method. In conclusion, middle and lower esophagectomies preceded by LTHA provides a good surgical view of the posterior mediastinum, markedly shortens the duration of one-lung ventilation and improves the perioperative outcome. IntroductionEsophagectomies is associated with significant morbidity and mortality, although recent advances in surgical and postoperative management techniques have improved the treatment outcome (1). Respiratory morbidity, in particular, remains the most common serious complication following esophagectomy and a number of studies demonstrated a respiratory complication rate of ~20% (2-5). Since the duration of one-lung ventilation is known to affect postoperative immune reactions and cause respiratory complications, it is crucial to reduce the intrathoracic operative time (6,7).We first performed an esophagectomy preceded by the laparoscopic transhiatal approach (LTHA) for patients with esophageal cancer in 2009 (8-10). With this method, carbon dioxide is introduced into the mediastinum from the abdominal side of the diaphragm and middle and lower mediastinal operations may be performed via a transhiatal approach. The main advantages of this method are that the thoracic procedures performed via right thoracotomy may be simplified and the duration of one-lung ventilation may be shortened. In addition, a good surgical view of the lower mediastinum is obtained and the quality of the mediastinal surgery may be improved. By December, 2012, a total of 121 pa...

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Lymphadenectomy along the left recurrent laryngeal nerve by a minimally invasive esophagectomy in the prone position for thoracic esophageal cancer

Abstract: A thoracoscopic esophagectomy in the prone position is technically safe and feasible and provides better surgeon ergonomics and better operative exposure around the left recurrent laryngeal nerve during an aggressive esophagectomy.

Cited by 154 publications

References 29 publications

Thoracoscopic-Laparoscopic Esophagectomy for Carcinoma of the Esophagus: Preliminary Reports of Seven Cases from the High-Volume Institution

Thoracoscopic-Laparoscopic Esophagectomy for Carcinoma of the Esophagus: Preliminary Reports of Seven Cases from the High-Volume Institution

Thoracoscopic Esophagectomy in Supine Position

Middle and lower esophagectomy preceded by hand-assisted laparoscopic transhiatal approach for distal esophageal cancer

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