Outcomes following laparoscopic transhiatal esophagectomy for esophageal cancer

Cash, J. Christian; Zehetner, Joerg; Hedayati, Bobak; Bildzukewicz, Nikolai A.; Katkhouda, Namir; Mason, Rodney J.; Lipham, John C.

doi:10.1007/s00464-013-3230-y

Cited by 21 publications

(30 citation statements)

References 58 publications

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“…There have been four comparative studies of conventional open and laparoscopic THE. (17)(18)(19)(20)(21) Based on these studies, the laparoscopic THE group had significantly less blood loss than the open THE group, but no differences in operation times were evident between the groups. Although overall morbidity tended to be lower in the laparoscopic THE group, the pulmonary complication rates did not differ.…”

Section: Laparoscopic Thementioning

confidence: 91%

“…Since the first report by DePaula et al in 1995, many studies on laparoscopic THE have been reported, mostly for distal and junction cancer in Western countries. There have been four comparative studies of conventional open and laparoscopic THE . Based on these studies, the laparoscopic THE group had significantly less blood loss than the open THE group, but no differences in operation times were evident between the groups.…”

Section: Laparoscopic Thementioning

confidence: 99%

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Transmediastinal approach for esophageal cancer: A new trend toward radical surgery

Fujiwara

Shiozaki

Konishi

et al. 2019

Asian J Endoscop Surgery

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Esophageal squamous cell carcinoma (ESCC), the most common histology of esophageal cancer in Japan and Asia, shows extensive mediastinal spread from an early stage. Therefore, transthoracic esophagectomy with extensive mediastinal lymphadenectomy, including in the upper mediastinum along the recurrent laryngeal nerves, is the gold standard of radical surgery for ESCC. Minimally invasive thoracoscopic esophagectomy has now become a standard option for ESCC. However, transhiatal esophagectomy is regarded as less invasive because it avoids thoracotomy. Yet, it is also considered less curative because it offers a limited surgical view and insufficient mediastinal lymphadenectomy even when conventional specialized mediastinoscopy is used. Recent clinical studies on radical esophagectomy without thoracotomy for ESCC have been reported from Japan. The introduction of novel minimally invasive techniques for the transcervical or transhiatal approach, such as single‐port or robotic surgical devices, have enabled transmediastinal radical esophagectomy for ESCC. This review focuses on the transmediastinal approach for esophageal cancer surgery, which employs minimally invasive techniques to reduce morbidity, and its application to radical surgery for ESCC.

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Section: Laparoscopic Thementioning

confidence: 91%

Section: Laparoscopic Thementioning

confidence: 99%

Transmediastinal approach for esophageal cancer: A new trend toward radical surgery

Fujiwara

Shiozaki

Konishi

et al. 2019

Asian J Endoscop Surgery

View full text Add to dashboard Cite

show abstract

“…Furthermore, by avoiding patient's repositioning during the procedure, this approach benefits from a shorter operative time [12 • ]. However, this comes at the cost of a poorer visualization of the intrathoracic esophagus and minimal lymphatic dissection in the thorax [13]. Data from one of the largest studies comparing laparoscopic with open transhiatal esophagectomies showed that transhiatal MIE was associated with a shorter hospital and intensive care unit stay, with similar operative time and morbidity [14].…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…Also of note, the magnified visualization offered by the laparoscopic camera may allow for less 'blind' mediastinal dissection, therefore reducing blood loss. This is particularly relevant in transhiatal MIE compared to other MIE techniques that involve direct thoracic visualization [13].…”

Section: Surgical Techniquesmentioning

confidence: 99%

Minimally Invasive Esophagectomy: Are There Significant Benefits?

Mungo

Molena

2014

Curr Surg Rep

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The incidence of esophageal cancer and, more specifically, of esophageal adenocarcinoma, continues to increase in the United Sates (US), mostly affecting white male patients. The mainstay of curative treatment for localized disease is surgery, typically after neoadjuvant chemoradiotherapy. However, esophagectomy remains a procedure burdened by significant rates of mortality and morbidity. Over the last two decades minimally invasive techniques have been adapted to esophageal resection, with the goal of improving postoperative outcomes without compromising oncological success. Numerous reports have documented the safety and feasibility of minimally invasive esophagectomy (MIE), and several centers have gained considerable experience in the technique and gathered a large case series. The overall advantage of MIE over open techniques in regards to improved outcomes and cost effectiveness remains controversial. The aim of the present work is to review the key aspects of MIE and compare the results with open surgery. Keywords Minimally invasive esophagectomy Á Outcomes of esophagectomy Á Transhiatal esophagectomy Á Ivor Lewis esophagectomy Á 3-Field esophagectomy Á Esophageal cancer Á Laparoscopy Á Thoracoscopy This article is part of the Topical Collection on Esophageal/Reflux Surgery.

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“…Presently, minimally invasive surgery and open surgery are two methods in abdominal operations . Both methods cannot avoid a postoperative acute wound pain.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia in abdominal surgery: A meta‐analysis of randomised controlled trials

Ren

Shi

Chen

et al. 2019

International Wound Journal

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To assess the efficacy and safety of dexmedetomidine (DEX) as an adjuvant to local wound infiltration anaesthesia in abdominal surgery, we conducted this meta‐analysis. First, the systematic search strategy was performed on PubMed, Embase, and Cochrane Library and five randomised controlled trials (RCTs) involving 294 patients were included. Then, the outcome data were extracted from the studies and their effect sizes were calculated using Review Manager 5. As a result, the addition of DEX significantly reduced visual analogy scores at 6 hours after surgery (mean difference = −0.53[−0.82, −0.25], P < .001), 12 hours after surgery (mean difference = −0.39 [−0.73, −0.05]; P = .03), and 24 hours after surgery (mean difference = −0.20 [−0.29, −0.11], P < .001) and reduced total analgesic consumption within 24 hours after surgery (mean difference = −4.92 [−9.00, −0.84]; P = .02) compared with placebo groups. However, there was no difference in the incidence of postoperative nausea and vomiting (risk ratio = 0.68 [0.41, 1.14]; P = .14). In summary, DEX as a local anaesthetic adjuvant added for local wound infiltration anaesthesia in abdominal surgery could reduce visual analogy scores and postoperative analgesic consumption without changing incidence of postoperative nausea and vomiting.

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Outcomes following laparoscopic transhiatal esophagectomy for esophageal cancer

Abstract: LTE can be performed safely with less major complications and shorter hospital stay than open esophagectomy. The reduced lymph-node harvest did not impact overall survival.

Cited by 21 publications

References 58 publications

Transmediastinal approach for esophageal cancer: A new trend toward radical surgery

Transmediastinal approach for esophageal cancer: A new trend toward radical surgery

Minimally Invasive Esophagectomy: Are There Significant Benefits?

Efficacy of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia in abdominal surgery: A meta‐analysis of randomised controlled trials

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