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Minimally invasive esophagectomy

Jan A H Gooszen, Annelijn E Slaman, Susan van Dieren, Suzanne S Gisbertz, Mark I van Berge Henegouwen
BACKGROUND: Diaphragmatic hernias following esophagectomy are mostly asymptomatic. However, they can also present with severe complications and be associated with high morbidity and mortality rates. The aim of this study was to assess the incidence, predictive factors and preferred treatment of symptomatic diaphragmatic hernias and to evaluate the role of prophylactic cruroplasty in patients following esophagectomy for carcinomas of the esophagus or gastro-esophageal junction. METHODS: A prospective database was used to retrospectively analyze consecutive patients who underwent esophagectomy between January 2005 and December 2015...
March 16, 2018: Annals of Thoracic Surgery
Tsz Yeung Kam, Melpomeni Kountouri, Arnaud Roth, Frossard Jean-Loui, Olivier Huber, Stefan Mönig, Thomas Zilli
Radical esophagectomy with extended lymph node dissection is considered the standard of care in treatment of squamous cell carcinoma of esophagus with deep mucosal invasion (pT1a m3) or submucosal involvement (pT1b). However, despite the increasing use of minimally invasive approaches, it remains a major surgery associated with significant morbidities and even mortality risk. Endoscopic resection (ER) results in excellent local control in early superficial mucosal (pT1a) disease yet there is substantial risk of lymph node metastases in T1b disease...
April 2018: Critical Reviews in Oncology/hematology
H-Y Deng, W-X Huang, G Li, S-X Li, J Luo, G Alai, Y Wang, L-X Liu, Y-D Lin
Whether the robot-assisted minimally invasive esophagectomy (RAMIE) has any advantages over the video-assisted minimally invasive esophagectomy (VAMIE) remains controversial. In this study, we tried to compare the short-term outcomes of RAMIE with that of VAMIE in treating middle thoracic esophageal cancer from a single medical center. Consecutive patients undergoing RAMIE or VAMIE for middle thoracic esophageal cancer from April 2016 to April 2017 were prospectively included for analysis. Baseline data and pathological findings as well as short-term outcomes of these two group (RAMIE group and VAMIE group) patients were collected and compared...
March 9, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Naoya Yoshida, Kenichi Nakamura, Daisuke Kuroda, Yoshifumi Baba, Yuji Miyamoto, Masaaki Iwatsuki, Yukiharu Hiyoshi, Takatsugu Ishimoto, Yu Imamura, Masayuki Watanabe, Hideo Baba
BACKGROUND: Preoperative smoking cessation is considered integral to decreasing postoperative morbidities after esophagectomy. To our knowledge, the association of the duration of smoking cessation with the occurrence of postoperative morbidity has never been investigated in minimally invasive esophagectomy (MIE). METHODS: A total of 198 consecutive MIEs for esophageal cancer between June 2011 and December 2017 were eligible for the study. According to the length of smoking cessation, patients were separated into three groups: ≤ 30, 31-90, and ≥ 91 days...
March 12, 2018: World Journal of Surgery
L R van der Werf, J L Dikken, M I van Berge Henegouwen, V E P P Lemmens, G A P Nieuwenhuijzen, B P L Wijnhoven
BACKGROUND: For esophageal cancer, the number of retrieved lymph nodes (LNs) is often used as a quality indicator. The aim of this study is to analyze the number of retrieved LNs in The Netherlands, assess factors associated with LN yield, and explore the association with short-term outcomes. This is a population-based study on lymph node retrieval in patients with esophageal cancer, presenting results from the Dutch Upper Gastrointestinal Cancer Audit. STUDY DESIGN: For this retrospective national cohort study, patients with esophageal carcinoma who underwent esophagectomy between 2011 and 2016 were included...
March 9, 2018: Annals of Surgical Oncology
Emanuele Asti, Gianluca Bonitta, Matteo Melloni, Stefania Tornese, Pamela Milito, Andrea Sironi, Elena Costa, Luigi Bonavina
BACKGROUND: Early detection of anastomotic leakage after esophagectomy has the potential to reduce morbidity and mortality. Prompt suspicion of leak may help to exclude patients from fast-track protocols, thereby avoiding early oral feeding and early hospital discharge which could aggravate the prognosis of a clinically occult leak. PATIENTS AND METHODS: Observational retrospective cohort study. Patients with diagnosis of esophageal cancer who underwent elective minimally invasive esophagectomy were included...
March 7, 2018: Langenbeck's Archives of Surgery
Florin Achim, Silviu Constantinoiu
The treatment of esophageal cancer has become more effective due to advances in surgical techniques, multidisciplinary approach, appropriate use of neoadjuvant therapy and perioperative care at centers of excellence in esophageal surgery. Esophagectomy is one of the most complicated and demanding procedures among all gastrointestinal surgeries with a very long learning curve in which excellence can only be achieved through improvement during all the surgical career. The results of esophagectomy are related not only to the volume of cases operated but also to the experience of surgeons in the management of postoperative complications...
January 2018: Chirurgia
Francesco Guerra, Alessandra Vegni, Elena Gia, Stefano Amore Bonapasta, Michele Di Marino, Mario Annecchiarico, Andrea Coratti
BACKGROUND: Over recent decades, minimally invasive esophagectomy has gained popularity and is increasingly performed worldwide. The aim of this work was to investigate the perioperative, clinicopathologic, and oncological outcomes of robot-assisted esophagectomy on a consecutive series of totally robotic procedures. METHODS: All patients received either an Ivor Lewis or a McKeown procedure according to tumor location. Perioperative, clinicopathologic and oncological outcomes were examined...
March 6, 2018: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Baihua Zhang, Junliang Ma, Xinjian Yan, Xu Li, Qin Xiao, Wenxiang Wang, Yong Zhou
RATIONALE: Minimally invasive esophagectomy (MIE) have been increasingly used and are regarded as suitable alternatives to open esophagectomy. However, few previous reports described minimally invasive esophagectomy using a left-sided approach. PATIENT CONCERNS AND DIAGNOSES: A 71-year-old man was admitted to our hospital because of progressive dysphagia. Synchronous double primary thoracic esophageal and left lung cancers were considered before the operation. INTERVENTIONS AND OUTCOMES: A lobectomy and MIE, via a left video-assisted thoracoscopic approach, was performed...
January 2018: Medicine (Baltimore)
Pieter C van der Sluis, Jelle P Ruurda, Sylvia van der Horst, Lucas Goense, Richard van Hillegersberg
BACKGROUND: Robot-assisted minimally invasive thoraco-laparoscopic esophagectomy (RAMIE) was developed in 2003. RAMIE was shown to be safe and oncologically effective. The aim of this study was to assess the learning curve and the proctoring program for a newly introduced surgeon (surgeon 2). METHODS: The "learning curve" was defined as the number of operations that must be performed by a surgeon to achieve a steady level of performance. Measures of proficiency to describe the learning curve of the proctor and the newly introduced surgeon 2 included: operating time, blood loss and conversion rates and were analyzed using the cumulative sum (CUSUM) method...
February 15, 2018: Annals of Thoracic Surgery
Hai-Xiang Yu, Chun-Shan Han, Jin-Ru Xue, Zhi-Feng Han, Hua Xin
Esophageal hiatal hernia involves abnormal abdominal entry into thoracic cavity. It is classified based on orientation between esophageal junction and diaphragm. Sliding hiatal hernia (Type-I) comprises the most frequent category, emanating from right crus of diaphragm. Type-II esophageal hernia engages both left and right muscular crura. Type-III and IV additionally include the left crus. Age and increased body mass index are key risk factors, and congenital skeletal aberrations trigger pathogenesis through intestinal malrotations...
April 2018: Expert Review of Gastroenterology & Hepatology
Dong Zhou, Quan-Xing Liu, Xu-Feng Deng, Hong Zheng, Xiao Lu, Ji-Gang Dai, Li Jiang
Purpose: Anastomotic leakage is the most feared postoperative complication after esophagectomy. Omentoplasty, wrapping the omentum around the alimentary tract anastomosis, is thought to decrease the anastomotic leakage rate. The purpose of this clinical study is to investigate the use of omentoplasty to reinforce cervical esophagogastrostomy after minimally invasive esophagectomy (MIE). Patients and methods: In this retrospective study, the data of 160 consecutive patients who underwent cervical esophagogastrostomy after MIE between September 2012 and May 2015 were analyzed, 87 who underwent omentoplasty (group A) and 73 who did not undergo omentoplasty (group B)...
2018: Cancer Management and Research
D Mege, L Depypere, G Piessen, A E Slaman, B P L Wijnhoven, A Hölscher, M Nilsson, M I van Berge Henegouwen, J J B van Lanschot, W Schroeder, P A Thomas, P Nafteux, X B D'Journo
Esophageal sarcomas are rare and evidence in literature is scarce making their management difficult. The objective is to report surgical and oncological outcomes of esophageal sarcoma in a large multicenter European cohort. This is a retrospective multicenter study including all patients who underwent en-bloc esophagectomy for esophageal sarcoma in seven European tertiary referral centers between 1987 and 2016. The main outcomes and measures are pathological results, early and long-term outcomes. Among 10,936 esophageal resections for cancer, 21 (0...
February 9, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
K Kosumi, N Yoshida, K Okadome, T Eto, D Kuroda, M Ohuchi, Y Kiyozumi, K Nakamura, D Izumi, R Tokunaga, K Harada, K Mima, H Sawayama, T Ishimoto, M Iwatsuki, Y Baba, Y Miyamoto, M Watanabe, H Baba
Evidence suggests that minimally invasive esophagectomy has several advantages with regard to short-term outcomes, compared to open esophagectomy in esophageal cancer patients. However, the impact of minimally invasive esophagectomy on long-term respiratory function remains unknown. The objective of this study is to assess the association between use of the minimally invasive esophagectomy and long-term respiratory dysfunction in esophageal cancer patients after esophagectomy. This retrospective single institution study using prospectively collected data included 87 consecutive esophageal cancer patients who had undergone esophagectomy...
February 9, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Masanobu Nakajima, Hiroyuki Kato, Hiroto Muroi, Maiko Kikuchi, Masakazu Takahashi, Satoru Yamaguchi, Kinro Sasaki, Hitoshi Ishikawa, Hideyuki Sakurai, Hiroyuki Kuwano
BACKGROUND/AIMS: Because salvage surgery after definitive chemoradiotherapy for esophageal cancer is associated with high postoperative mortality and morbidity, minimally invasive methods are desirable. We analyzed the validity of minimally invasive salvage operations (MISO). METHODS: Twenty-five patients underwent salvage operation between 2010 and 2016 in our institution, 10 having undergone right transthoracic salvage esophagectomy (TTSE group), 6 transhiatal salvage esophagectomy (THSE), 6 salvage lymphadenectomy (SLA), and 3 salvage endoscopic submucosal dissection (SESD)...
February 1, 2018: Digestion
N Niclauss, M Chevallay, J L Frossard, S P Mönig
Early stage carcinomas of the esophagus are histologically differentiated into adenocarcinomas and squamous cell carcinomas and subdivided into mucosal (m1-3) and submucosal (sm1-3) carcinomas depending on the infiltration depth. While the prevalence of lymph node metastases in mucosal carcinomas is very low, the probability of lymph node metastases increases from submucosal infiltration with increasing depth. According to the current German S3 guidelines endoscopic resection is the recommended treatment strategy for mucosal adenocarcinoma without histological risk factors (lymphatic invasion [L1], venous invasion [V1], poorly differentiated [>G2], microscopic residual disease [R1] at the deep resection margin)...
February 1, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Chao-Yu Liu, Chen-Sung Lin, Chih-Shiun Shih, Yuh-An Huang, Chia-Chuan Liu, Chih-Tao Cheng
INTRODUCTION: The cost-effectiveness of minimally invasive esophagectomy (MIE) versus open esophagectomy (OE) for esophageal squamous cell carcinoma (ESCC) has not been established. Recent cost studies have shown that MIE is associated with a higher surgical expense, which is not consistently offset by savings through expedited post-operative recovery, therefore suggesting a questionable benefit of MIE over OE from an economic point of view. In the current study, we compared the cost-effectiveness of MIE versus OE for ESCC...
January 29, 2018: World Journal of Surgery
Yunke Zhu, Xiaolong Zhang, Yang Hu, Lunxu Liu
Minimally invasive esophagectomy has several benefits as an effective alternative treatment for esophageal cancer. The three-phase esophageal resection may be the most popular approach to esophagectomy. Numerous thoracoport designs are available for the thoracoscopic procedure. The present study aims to contribute a distinctive three-port technique that is designed to minimize surgical trauma and facilitate operation during the thoracoscopic procedure. In this paper, we describe and demonstrate the details of the port design and each operation step...
January 22, 2018: Journal of Surgical Oncology
Yue Zhao, Yousheng Mao
Esophageal cancer is one of the most common malignant digestive system cancers in China, which has high incidence and mortality. Nowadays, surgery remains the most important part of the comprehensive treatments. Conventional open esophagectomies are highly traumatic with high morbidity, while minimally invasive esophagectomy has been increasingly used with the development of surgical instruments and techniques in recent years. Compared with conventional open esophagectomy(OE), what are the advantages of minimally invasive esophagectomy (MIE) and which is preferable? This review briefly introduces the developing history of MIE and common procedures...
January 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Santosh Anand, Raja Kalayarasan, Sandip Chandrasekar, Senthil Gnanasekaran, Biju Pottakkat
BACKGROUND: Neoadjuvant therapy followed by surgery is the current recommended treatment for locally advanced esophageal carcinoma. Thoracic duct (TD) resection was indicated for radical mediastinal lymphadenectomy. However, TD resection can cause hemodynamic disturbances. The presence of metastasis in TD has not been previously studied. METHODS: Twenty-two patients who underwent minimally invasive esophagectomy with D2 lymphadenectomy after neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma were analyzed...
January 18, 2018: Journal of Gastrointestinal Cancer
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