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Ivor lewis esophagectomy

Francesco Paolo Caronia, Alfonso Fiorelli, Mario Santini, Roberto Alfano, Sergio Castorina
We reported the management of a life-threatening condition as a large tracheo-gastric fistula involved the carina, the left and the right bronchus that complicated Ivor Lewis esophagogastrectomy for esophageal cancer. An urgent right thoracotomy was performed and the tracheal defect was covered with a reversed pedicled pericardial patch reinforced with an intercostal muscle flap. Cervical esophagostomy and a feeding jejunostomy completed the operation. Five months later, the continuity of gastrointestinal tract was restored using a transverse colon...
October 2016: Annals of Translational Medicine
R B Scott, L A Ritter, A L Shada, S H Feldman, D E Kleiner
Anastomotic leaks are a serious complication associated with Ivor Lewis esophagectomies. Endoluminal negative pressure vacuum devices create a possible treatment alternative to conventional surgical intervention. Ten pigs had an intrathoracic esophageal anastomosis with a 1-cm defect. The experimental group had the device placed intraoperatively across the defect, whereas the control group did not. Once treatment was completed, a contrast fluoroscopic study and necropsy was performed. All control pigs had contrast extravasation on fluoroscopy and contamination on necropsy...
November 11, 2016: Clinical and Translational Science
Hanlu Zhang, Longqi Chen, Yingcai Geng, Yu Zheng, Yun Wang
Thoracoscopic intrathoracic esophagogastrostomy is a technically demanding operation; these technical requirements restrict the extensive application of minimally invasive Ivor Lewis esophagectomy. In an attempt to reduce the difficulty of this surgical procedure, we developed a modified anastomotic technique for thoracolaparoscopic Ivor Lewis esophagectomy. During the entirety of this modified approach, neither technically challenging operations such as intrathoracic suturing, or knotting, nor special instruments such as an OrVil system or a reverse-puncture head are required...
October 21, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Alexander W Phillips, Barry Dent, Maziar Navidi, Arul Immanuel, S Michael Griffin
OBJECTIVE: The aim of the present study was to determine whether trainee involvement in esophageal cancer resection is associated with adverse patient outcomes. BACKGROUND: Operative experience for surgical trainees is under threat. A number of factors have been implicated in this leading to fewer hours for training. Esophagogastric cancer training is particularly vulnerable due to the publication of individual surgeon results and a perception that dual consultant operating improves patient outcomes...
October 17, 2016: Annals of Surgery
Qi Wang, Zixiang Wu, Gang Chen, Sai Zhang, Gang Shen, Ming Wu
Background Minimally invasive esophagectomy (MIE) Ivor Lewis has been increasingly performed over the last two decades. To guide the implementation of this technically demanding procedure, a comprehensive assessment of MIE-Ivor Lewis learning curves should include both the general competence to accomplish the procedure and the ability to generate oncological benefits. These objectives are believed to be associated with different phases of the learning curve. Methods A retrospective review of the first 109 patients who underwent MIE-Ivor Lewis by a single qualified surgeon was conducted...
October 5, 2016: Thoracic and Cardiovascular Surgeon
Saurabh Singhal, Aparna Kailasam, Shunsuke Akimoto, Takahiro Masuda, Carrie Bertellotti, Sumeet K Mittal
BACKGROUND: Advent of minimally-invasive esophagectomy necessitated the incorporation of stapled anastomotic techniques especially for intrathoracic anastomosis. We present our approach to the Ivor Lewis esophagectomy highlighting a simple modification in the anastomotic technique and review our experience with anastomotic outcomes. METHODS: With IRB approval, patients who underwent Ivor Lewis esophagectomy with circular-stapled end-to-end anastomosis (EEA) were identified, divided into three equal sequential cohorts (A, B, and C), and compared for perioperative outcome...
October 5, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Xiaodong Yang, Cheng Zhan, Fenghao Sun, Li Chen, Mengkun Shi, Wei Jiang, Qun Wang
OBJECTIVE: To compare the short-term efficacy and long-term survival between Sweet and Ivor-Lewis esophagectomy for patients with middle-lower esophageal squamous cell carcinoma. METHODS: Clinicopathologic data of 1 308 patients with middle-lower esophageal squamous cell carcinoma undergoing Sweet or Ivor-Lewis procedures in our department from January 2007 to December 2014 were retrospectively analyzed, including 1 021 patients of Sweet operation (Sweet group) and 287 patients of Ivor-Lewis operation(Ivor-lewis group)...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Sahar A Saddoughi, J Matthew Reinersman, Yuriy O Zhukov, James Taswell, Kristin Mara, S William Harmsen, Shanda H Blackmon, Stephen D Cassivi, Francis Nichols, K Robert Shen, Dennis A Wigle, Mark S Allen
BACKGROUND: Five-year survival of stage IV esophageal cancer is rare. The treatment of advanced esophageal cancer is typically palliative and the role of surgery remains controversial. We sought to understand the impact of curative surgery on survival and identify any favorable tumor or patient characteristics that might make surgical resection appropriate when treating stage IV esophageal cancer. METHODS: A retrospective review of 3,500 esophagectomies performed at our institution from 1985 to 2013 identified 52 (1...
September 9, 2016: Annals of Thoracic Surgery
Gavitt A Woodard, Jane C Crockard, Carolyn Clary-Macy, Clara T Zoon-Besselink, Kirk Jones, Wolfgang Michael Korn, Andrew H Ko, Alexander R Gottschalk, Stanley J Rogers, David M Jablons
BACKGROUND: There is a clear survival benefit to neoadjuvant chemoradiation prior to esophagectomy for patients with stages II-III esophageal cancer. A minimally invasive esophagectomy approach may decrease morbidity but is more challenging in a previously radiated field and therefore patients who undergo neoadjuvant chemoradiation may experience more postoperative complications. METHODS: A prospective database of all esophageal cancer patients who underwent attempted hybrid minimally invasive Ivor Lewis esophagectomy was maintained between 2006 and 2015...
August 28, 2016: Journal of Surgical Oncology
Robert J Cerfolio, Benjamin Wei, Mary T Hawn, Douglas J Minnich
Minimally invasive esophagectomy with intrathoracic dissection and anastomosis is increasingly performed. Our objectives are to report our operative technique, early results and lessons learned. This is a retrospective review of 85 consecutive patients who were scheduled for minimally invasive Ivor Lewis esophagectomy (laparoscopic or robotic abdominal and robotic chest) for esophageal cancer. Between 4/2011 and 3/2015, 85 (74 men, median age: 63) patients underwent robotic Ivor Lewis esophageal resection. In all, 64 patients (75%) had preoperative chemoradiotherapy, 99% had esophageal cancer, and 99% had an R0 resection...
2016: Seminars in Thoracic and Cardiovascular Surgery
Marco E Allaix, Jason M Long, Marco G Patti
The last 25 years have witnessed a steady increase in the use of minimally invasive esophagectomy for the treatment of esophageal cancer. However, it is unclear which the optimal minimally invasive approach is: totally minimally invasive or hybrid (laparoscopic assisted or thoracoscopic assisted)? The current evidence from nonrandomized control trials suggests that hybrid laparoscopic-assisted esophagectomy couples the benefits of laparoscopy and the advantages of thoracotomy, leading to reduced surgical trauma without jeopardizing survival compared with open esophagectomy...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Peng Ye, Jin-Lin Cao, Qiu-Yuan Li, Zhi-Tian Wang, Yun-Hai Yang, Wang Lv, Jian Hu
BACKGROUND: The greater omentum has been found to be immunologically competent in protecting abdominal organs from inflammation. Anastomotic omentoplasty has been used and proven effective in preventing anastomotic leaks after an esophagectomy. However, pulmonary complications are still a substantial problem after an esophagectomy. This study investigated the benefits of mediastinal transposition of the omentum, a modification of the conventional omental wrapping technique, in controlling overall postoperative intrathoracic complications...
July 2016: Journal of Thoracic Disease
David S Strosberg, Robert E Merritt, Kyle A Perry
BACKGROUND: Laparoscopic gastric devascularization (LGD) is an innovative method to improve gastric conduit perfusion and improve anastomotic healing following esophagectomy. This study reports our early experience with LGD performed two weeks prior to minimally invasive esophagectomy (MIE) with intrathoracic anastomosis. METHODS: We performed a retrospective review of all patients who underwent LGD prior to minimally invasive Ivor Lewis esophagectomy between August 2014 and July 2015 at a large academic medical center...
August 5, 2016: Surgical Endoscopy
Andrew P Barbour, Orla M Mc Cormack, Peter J Baker, Jodi Hirst, Lutz Krause, Sandra Brosda, Janine M Thomas, Jane M Blazeby, Iain G Thomson, David C Gotley, Bernard M Smithers
OBJECTIVE: The aim of this study was to assess long-term health-related quality of life (HRQL) in patients after thoracoscopic and open esophagectomy. SUMMARY OF BACKGROUND DATA: Trials comparing minimally invasive with open transthoracic esophagectomy have shown improved short-term outcomes; however, long-term HRQL data are lacking. This prospective nonrandomized study compared HRQL and survival after thoracoscopically assisted McKeown esophagectomy (TAMK) and open transthoracic Ivor Lewis esophagectomy (TTIL) for esophageal or gastroesophageal junction (GEJ) cancer...
July 15, 2016: Annals of Surgery
Danica N Giugliano, Adam C Berger, Ernest L Rosato, Francesco Palazzo
Since the introduction of minimally invasive esophagectomy 25 years ago, its use has been reported in several high volume centers. With only one published randomized control trial and five meta-analyses comparing its outcomes to open esophagectomy, available level I evidence is very limited. Available technical approaches include total minimally invasive transthoracic (Ivor Lewis or McKeown) or transhiatal esophagectomy; several hybrid options are available with one portion of the procedure completed via an open approach...
September 2016: Langenbeck's Archives of Surgery
E Van Daele, W Ceelen, T Boterberg, O Varinl, Y Van Nieuwenhove, D Van de Putte, K Geboes, P Pattyn
INTRODUCTION: Neoadjuvant chemoradiation (CRT) confers a survival benefit in locally advanced esophageal cancer. The optimal dose of radiotherapy remains undefined. METHODS: From a prospective database, we identified patients who received CRT followed by Ivor Lewis esophagectomy. Surgical complications, pathological response, and oncological outcome were compared between patients who received a radiotherapy (RT) dose of 36 Gy (group1) versus a dose of > 40 Gy (group 1)...
January 2015: Acta Chirurgica Belgica
Saibo Pan, Gang Shen, Ming Wu
OBJECTIVE: We present a "Reversal Penetrating Technique" (RPT) to perform thoracoscopic esophagogastric anastomosis in Ivor Lewis minimally invasive esophagectomy (MIE). The safety and efficiency of this technique are evaluated. PATIENTS AND METHODS: RPT was used in Ivor Lewis MIE for treating patients with distal esophageal cancer. A specific anvil set is inserted into proximal esophagus lumen to allow its prefixed Prolene suture to pierce from the inside out. Then, the suture is pulled until the anvil rod penetrates the esophageal wall...
June 20, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
M Bjelovic, T Babic, B Spica, D Gunjic, M Veselinovic, G Trajkovic
AIM: To assess the effectiveness of hybrid minimally invasive esophagectomy (hMIE) in comparison with open esophagectomy (OE) in esophageal cancer treatment. METHODS: The single center prospective nonrandom cohort study included a total of 88 patients in convenience sample, who underwent the Ivor-Lewis procedure with a curative intention for the middle- and lower-third esophageal cancer between January 2009 and February 2015. All patients were operated by the one surgical team...
August 2016: European Journal of Surgical Oncology
Sophia Y Chen, Daniela Molena, Miloslawa Stem, Benedetto Mungo, Anne O Lidor
AIM: To identify rates of post-discharge complications (PDC), associated risk factors, and their influence on early hospital outcomes after esophagectomy. METHODS: We used the 2005-2013 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to identify patients ≥ 18 years of age who underwent an esophagectomy. These procedures were categorized into four operative approaches: transhiatal, Ivor-Lewis, 3-holes, and non-gastric conduit...
June 14, 2016: World Journal of Gastroenterology: WJG
Laurent Poincloux, Constance Hordonneau, Olivier Rouquette
No abstract text is available yet for this article.
2016: Endoscopy
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