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Ivor lewis

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
Dong Lin, Ting Ye, Longfei Ma, Longlong Shao, Zuodong Song, Shujun Jiang, Jiaqing Xiang
OBJECTIVE: To compare the safety and efficacy between three-field lymphadenectomy and normative Ivor-Lewis two-field lymphadenectomy for thoracic esophageal squamous cell carcinoma METHODS: Clinical data of 375 patients with thoracic esophageal squamous cell carcinoma who underwent three-field lymphadenectomy(3FL) or Ivor-Lewis two-field lymphadenectomy(2FL, Ivor-Lewis) in Fudan University Shanghai Cancer Center during 2013 were retrieved and collected from electronic medical record system...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Fuxi Zhen, Sailei Shi, Lei Xue, Jinyuan Liu, Jinhua Luo
OBJECTIVE: To examine the relationship between gastric conduit width and postoperative early delayed gastric emptying (DGE) in patients with middle-lower esophageal carcinoma who underwent Ivor-Lewis operation. METHODS: Clinical data of 282 consecutive patients with middle-lower esophageal cancer who underwent the Ivor-Lewis operation by same surgical team in our department from January 2013 to June 2015 were retrospectively analyzed. Patients were divided into three groups according to the width of gastric conduit: width > 5...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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
Philippe Rinieri, Moussa Ouattara, Geoffrey Brioude, Anderson Loundou, Henri de Lesquen, Delphine Trousse, Christophe Doddoli, Pascal Alexandre Thomas, Xavier Benoit D'Journo
OBJECTIVES: It has been suggested that laparoscopic Ivor Lewis (IL) oesophagectomy reduces postoperative morbidity and mortality rates. However, data related to the long-term outcomes of this hybrid minimally invasive procedure are scarce. METHODS: All of the patients who had an IL oesophagectomy for cancer were extracted from a prospective database. Patients were matched one to one according to the surgical approach (laparoscopy versus laparotomy) and on the basis of a propensity score including eight variables: age, gender, American Society of Anaesthesiologists score, forced expiratory volume in 1 s, surgery (first-line treatment, after neoadjuvant treatment and salvage surgery), histology, location and pathological stage...
September 4, 2016: European Journal of Cardio-thoracic Surgery
Y A Qureshi, S-J Sarker, R C Walker, S F Hughes
OBJECTIVE: The purpose of this study was to investigate whether a long proximal oesophageal resection margin (PRM) is associated with improved survival after oesophagectomy for cancer and to identify the optimal margin to aim for in this patient group. METHODS: A prospectively maintained database identified 174 patients who underwent Ivor-Lewis oesophagectomy for cancer. Demographic, clinical, and pathological data were collected. X-tile software was used to identify the optimal resection point...
August 29, 2016: Annals of Surgical Oncology
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
M Fagevik Olsén, G Kjellby Wendt, E Hammerlid, U Smedh
BACKGROUND AND AIMS: There is a risk of decreased physical function, quality of life and persistent pain after open surgery for esophageal cancer. There are currently no studies that evaluate the effect of any postoperative intervention, including physical exercises, after this type of surgery. The aim of the study was therefore to evaluate the effect of a training intervention after Ivor-Lewis resection of the esophagus. MATERIAL AND METHODS: Patients scheduled for esophagus resection according to Ivor-Lewis were randomized to an intervention group or a control group...
July 1, 2016: Scandinavian Journal of Surgery: SJS
Robert J Cerfolio, Kyle M Bess, Benjamin Wei, Douglas J Minnich
BACKGROUND: Our objective is to report our incidence, results, and technique for the control of major vascular injuries during minimally invasive robotic thoracic surgery. METHODS: This is a consecutive series of patients who underwent a planned robotic thoracic operation by one surgeon. RESULTS: Between February 2009 and September 2015, 1,304 consecutive patients underwent a robotic operation (lobectomy, n = 502; segmentectomy, n = 130; mediastinal resection, n = 115; Ivor Lewis, n = 103; thymectomy, n = 97; and others, n = 357) by one surgeon...
August 2016: Annals of Thoracic Surgery
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
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