Totally laparoscopic transhiatal esophago-gastrectomy without thoracic or cervical access: The least invasive surgery for adenocarcinoma of the cardia?

Costi, Roberta; Himpens, Jacques; Bruyns, Jean Andre; Cadière, Guy-Bernard

doi:10.1007/s00464-003-9053-5

Cited by 26 publications

(21 citation statements)

References 20 publications

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“…All the specimens were free of disease. The median number of mediastinal/periesophageal lymph nodes was 3 (range, 1-10) for group A and 4 (range, 2-13) for group B (NS), and the median number of celiac/perigastric lymph nodes was 11 (range, 2-31) for group A and 10 (range, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] for group B (NS). After a median follow-up period of 42.4 months (range, 2-84 months) for group A and 19.1 months (range, 1.5-34 months) for group B, 12 patients in group A died after a median period of 22 months (range, 2-55 months), and 7 patients in group B died after a median time of 15 months (range, 1.5-23 months).…”

Section: Resultsmentioning

confidence: 99%

Minimally invasive esophagectomy for cancer: laparoscopic transhiatal procedure or thoracoscopy in prone position followed by laparoscopy?

2007

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Section: Resultsmentioning

confidence: 99%

Minimally invasive esophagectomy for cancer: laparoscopic transhiatal procedure or thoracoscopy in prone position followed by laparoscopy?

2007

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“…Many reports described laparoscopic esophagectomy and gastric transposition for the treatment of different benign and malignant esophageal diseases in adults [19][20][21][22]. However, few reports described it in children [8,23,24].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopically assisted transhiatal esophagectomy with esophagogastroplasty for post-corrosive esophageal stricture treatment in children

et al. 2007

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A tight post-corrosive esophageal stricture in a child poses significant surgical challenges. Many studies have described minimally invasive esophagectomy in adults, but very few reports have described this technique in children. Minimally invasive esophagectomy represents a new alternative to conventional open esophagectomy. This retrospective study evaluated the safety and efficacy of laparoscopically assisted transhiatal esophagectomy and gastric transposition for post-corrosive esophageal stricture treatment. Twenty-seven children with post-corrosive esophageal stricture were subjected to this technique. Their ages ranged from 3 to 13.5 years (mean 5.6 years). Fourteen were females and thirteen were males. None of the procedures needed to be converted to an open approach, and there were neither intra-operative complications nor increased blood loss. Left-sided pneumothorax occurred in one case only (3.7%). The mean operating time was 160 min (range 120-180). Three patients were admitted postoperatively to intensive care unit for a period of 48 h for assisted ventilation. Mean hospital stay was 4 days (range 3-7 days). Anastomotic leakage occurred in three patients (11.1%), while anastomotic stricture occurred in four patients (14.8%). About 93.5% of our cases have achieved excellent results. Post-operative nutritional status was satisfactory and accepted. Laparoscopically assisted transhiatal esophagectomy and gastric transposition for post-corrosive esophageal stricture treatment in children is safe, visible, effective, and an accepted operative technique. The cosmetic result is excellent.

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“…These include early division of the vagus nerves to avoid inferiorly oriented RLN traction, clean and careful cervical esophageal dissection, and avoiding placement of retractors in the tracheoesophageal groove during the cervical phase of ER [1,17]. Furthermore, novel approaches to esophageal mobilization have been introduced that may reduce the likelihood for RLN-related complications [9,12,18], although this remains speculative. Upon identification of postesophagectomy swallowing abnormalities, various rehabilitation techniques may also be instituted to help prevent aspiration and subsequent respiratory complications, including the chin tuck maneuver and swallowing exercises [19,20].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Respiratory Complications After Minimally Invasive Esophagectomy: Preliminary Observation of Persistent Aspiration Risk

2006

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Minimally invasive (MI) esophageal resection (ER) has the theoretical advantage of reduced postoperative complications compared with standard ER. However, the impact of MIER on rates and severity of pulmonary complications is unclear. Four patients underwent laparoscopic gastroesophageal mobilization and resection followed by gastric pull-up and cervical esophageal anastomosis (MIER). Videofluoroscopic swallowing studies (VFSS) assessed pharyngolaryngeal function postoperatively. All postoperative complications were documented. Each MIER was completed successfully without intraoperative complications. Mean operative time was 4.3 +/- 2 h. Postoperatively, VFSS detected laryngeal penetration, vocal cord paralysis, and/or aspiration in three patients, two of whom experienced severe respiratory complications. MIER patients are susceptible to aspiration, likely due to transient denervation of the pharynx and laryngeal structures. Following MIER, aggressive pulmonary toilet and aspiration precautions are emphasized to reduce pulmonary complications. Furthermore, serial evaluation of deglutition is encouraged to guide the safe and appropriate resumption of oral feeding.

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Totally laparoscopic transhiatal esophago-gastrectomy without thoracic or cervical access: The least invasive surgery for adenocarcinoma of the cardia?

Abstract: In selected cases, it is possible to perform a distal esophagectomy entirely by laparoscopy, without the need for any thoracic or cervical access.

Cited by 26 publications

References 20 publications

Minimally invasive esophagectomy for cancer: laparoscopic transhiatal procedure or thoracoscopy in prone position followed by laparoscopy?

Minimally invasive esophagectomy for cancer: laparoscopic transhiatal procedure or thoracoscopy in prone position followed by laparoscopy?

Laparoscopically assisted transhiatal esophagectomy with esophagogastroplasty for post-corrosive esophageal stricture treatment in children

Analysis of Respiratory Complications After Minimally Invasive Esophagectomy: Preliminary Observation of Persistent Aspiration Risk

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