Minimally invasive transhiatal esophagectomy: lessons learned

Sanders, Grant; Borie, F.; Husson, Emanuel; Mauro, G; Claus, Christiano Marlo Paggi; Millat, Bertrand

doi:10.1007/s00464-007-9312-y

Cited by 23 publications

(12 citation statements)

References 20 publications

(31 reference statements)

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“…Both strategies have been shown to be feasible and safe, with minimally invasive techniques providing comparable short-and long-term outcomes [22][23][24]. In our study, transhiatal procedures were not included in order to focus on the comparison between open and minimally invasive transthoracic esophagectomy.…”

Section: Discussionmentioning

confidence: 99%

Open versus minimally invasive esophagectomy: a single-center case controlled study

et al. 2010

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Section: Discussionmentioning

confidence: 99%

Open versus minimally invasive esophagectomy: a single-center case controlled study

et al. 2010

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“…For carcinomas of the lower thoracic esophagus, different tumor characteristics between the Western and Eastern countries cause various attitudes on their surgical management [4] . Depending on the attending surgeon's philosophy, surgical approaches to carcinomas of the lower thoracic esophagus vary from the conventional left thoraco-abdominal approach [5,6] to the transhiatal approach without thoracotomy [7][8][9] , Ivor Lewis approach [10][11][12] , and recently reported thoracoscopic approach [13][14][15] . On the other hand, controversy continues over the optimal extent of lymphadenectomy to be performed with esophagectomy.…”

Section: Introductionmentioning

confidence: 99%

Ivor Lewis subtotal esophagectomy with two-field lymphadenectomy for squamous cell carcinoma of the lower thoracic esophagus

Wu¹,

Chai²,

Xiao-fang³

et al. 2008

WJG

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with two-field (total mediastinum) lymphadenectomy is a safe and appropriate operation for squamous cell carcinoma of the lower thoracic esophagus. INTRODUCTIONRadical esophag ectomy with lymphadenectomy remains the mainstay of curative therapy for esophageal carcinoma. Complete resection of esophagus and regional lymph node (R 0 resection) are essential to improve longterm survival [1][2][3] . For carcinomas of the lower thoracic esophagus, different tumor characteristics between the Western and Eastern countries cause various attitudes on their surgical management [4] . Depending on the attending surgeon's philosophy, surgical approaches to carcinomas of the lower thoracic esophagus vary from the conventional left thoraco-abdominal approach [5,6] to the transhiatal approach without thoracotomy [7][8][9] , Ivor Lewis approach [10][11][12] , and recently reported thoracoscopic approach [13][14][15] . On the other hand, controversy continues over the optimal extent of lymphadenectomy to be performed with esophagectomy. Some authors do not favor lymphadenectomy considering lymph node involvement as systemic disease with no hope for cure, and the primary goal of surgical intervention is palliative, with a low surgical morbidity and mortality [8] . However, some authors prefer two-field lymphadenectomy and regard it as a standard surgical procedure [10,12,16] . What is more, other authors, mainly from Japan, advocate threefield lymphadenectomy in order to obtain accurate staging, RESULTS:The operative morbidity and mortality was 15.1% and the mortality was 2.7%. Lymph node metastases were found in 52 patients (71.2%). Nodal metastases to the upper, middle, lower mediastini and upper abdomen were found in 13 (17.8%), 15 (20.5%), 30 (41.1%), and 25 (34.2%) patients, respectively. Postoperative staging was as follows: stageⅠ in 5 patients, stage Ⅱ in 34 patients, stage Ⅲ in 32 patients, and stage Ⅳ in 2 patients, respectively. The overall 5-year survival rate was 23.3%. For N0 and N1 patients, the 5-year survival rate was 38.1% and 17.3%, respectively (χ 2 = 22.65, P < 0.01). The 5-year survival rate for patients in stages Ⅱa, Ⅱb and Ⅲ was 31.2%, 27.8% and 12.5%, respectively (χ 2 = 29.18, P < 0.01).

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“…Desde 1993 8 , vários autores começaram a relatar sua experiência com a abordagem minimamente invasiva para esofagectomia.…”

Section: Discussionunclassified

“…DePaula et al 8 relataram, já em 1995, sua experiência com 48 esofagectomias, a maioria por megaesôfago grau IV.…”

Section: Discussionunclassified

Esofagogastrectomia vídeo-assistida para adenocarcinoma da transição esofagogástrica

Brandalise

Aranha

Brandalise

et al. 2007

ABCD, arq. bras. cir. dig.

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InTRODUÇÃOA incidência de adenocarcinoma do esôfago distal e cárdia vem crescendo muito nas últimas décadas nos países ocidentais. Em estudo publicado em 1991, analisando dados sobre a incidência de câncer em nove áreas dos Estados Unidos no período entre 1976 e 1987, observou-se incremento de 4% a 10% por ano -excedendo qualquer outro tipo de câncer .Em meados dos anos 80, metade das neoplasias gástricas eram adenocarcinomas de cárdia, e elas representavam um terço de todas as neoplasias de esôfago . Em outro estudo, a incidência de adenocarcinoma da junção esofagogástrica subiu de 0,6 para 2,2 por 100.000 pessoas-ano comparando as décadas de 1971-1980 com 1991-2000 . O aumento da obesidade nos paises ocidentais pode estar associado à essas observações 3 .O presente estudo teve por objetivo relatar a experiência com a técnica de esofagectomia vídeo-assistida, transhiatal para o tratamento de adenocarcinoma da transição esofagogástrica. ABCDDV/547Brandalise A, Aranha NC, Brandalise NA, Lorenzetti C, Pires CS. Esofagogastrectomia vídeo-assistida para adenocarcinoma da transição esofagogástrica.ABCD Arq Bras Cir Dig 2007;20(3):143-5. RESUMO -Racional -Nas últimas décadas observou-se expressivo aumento na incidência de adenocarcinoma da transição esofagogástrica. Concomitante a este aumento, houve progresso na cirurgia minimamente invasiva. Objetivo -Relatar a experiência com a técnica de esofagectomia vídeo-assistida, transhiatal para o tratamento de adenocarcinoma da transição esofagogástrica. MÉTODOSFoi feita análise retrospectiva dos casos de adenocarcinoma de cárdia operados pelos autores entre setembro de 1997 a maio de 2006. Nesse período, indicou-se ressecção por laparoscopia em 30 pacientes. Vinte e dois eram do sexo masculino (73%) e a idade média era de 55 anos.Segundo a classificação de Siewert, dividiram-se em oito casos do tipo I, 11 do tipo II e 11 do tipo III. Na abordagem inicial da cavidade, após analisarem-se fatores locais, decidiu-se mudar a via de acesso para laparotomia em 11 casos, para preservar a radicalidade oncológica. As neoplasias do tipo III foram as que mais fizeram mudar de tática operatória, sendo empregada a laparotomia em seis casos (54,5%). Nos tipos I e II, o acesso laparoscópico foi mantido em 75% e 73% dos casos, respectivamente.

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Minimally invasive transhiatal esophagectomy: lessons learned

Cited by 23 publications

References 20 publications

Open versus minimally invasive esophagectomy: a single-center case controlled study

Open versus minimally invasive esophagectomy: a single-center case controlled study

Ivor Lewis subtotal esophagectomy with two-field lymphadenectomy for squamous cell carcinoma of the lower thoracic esophagus

Esofagogastrectomia vídeo-assistida para adenocarcinoma da transição esofagogástrica

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