Minimally Invasive 3-Field Esophagectomy With Cervical Single-port Access

BACKGROUND:Minimally invasive esophagectomy for esophageal cancer include thoracoscopic and laparoscopic esophagectomy with a cervical single-port assist, which is inadequate for both techniques. This is the first reported series applying this technique to treat esophageal cancer patients in literat...

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Published in:	Surgical laparoscopy, endoscopy & percutaneous techniques Vol. 24; no. 4; pp. e151 - e154
Main Authors:	Guven, Hakan, Karahan, Servet R, Koc, Bora, Erdogu, Volkan, Ozsoy, Ayhan, Adas, Gokhan T, Bayram, Onur
Format:	Journal Article
Language:	English
Published:	United States by Lippincott Williams & Wilkins 01-08-2014
Subjects:	Adult Aged Carcinoma, Squamous Cell - diagnosis Carcinoma, Squamous Cell - surgery Endosonography Equipment Design Esophageal Neoplasms - diagnosis Esophageal Neoplasms - surgery Esophageal Squamous Cell Carcinoma Esophagectomy - methods Female Humans Laparoscopes Laparoscopy - instrumentation Length of Stay - trends Male Mediastinum Middle Aged Minimally Invasive Surgical Procedures - instrumentation Operative Time Positron-Emission Tomography Retrospective Studies Thoracoscopes Thoracoscopy - instrumentation Tomography, X-Ray Computed Treatment Outcome
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Summary:	BACKGROUND:Minimally invasive esophagectomy for esophageal cancer include thoracoscopic and laparoscopic esophagectomy with a cervical single-port assist, which is inadequate for both techniques. This is the first reported series applying this technique to treat esophageal cancer patients in literature. MATERIALS AND METHODS:From March 2007 to April 2011, 12 cases of laparoscopic and thoracoscopic total esophagectomy with a cervical single-port assist were performed. Indications for minimally invasive esophagectomy included esophageal squamous cell carcinoma, diagnosed preoperatively in nonmetastatic tumors and fewer than 4 lymph nodes by endoscopic ultrasonography. RESULTS:The mean operative time was 440 minutes (range, 347 to 578 min). The mean intensive care stay was 1.6 days (range, 0 to 6 d). The mean hospital stay was 11.8 days (range, 7 to 22 d). Minor complications included atrial fibrillation (n=1), pleural effusion (n=2), and persistent air leaks (n=1), and major complications included cervical anastomotic leak in 1 patient due to technical failure. The 30-day mortality rate was 0. CONCLUSIONS:Video-assisted thoracoscopic and laparoscopic esophagectomy combined with a cervical single-port assist is a safe and minimally invasive technique for whole esophagus and mediastinal lymph node dissection. This technique allows for the clear visualization of the mediastinum, reducing the risk of surgery-related trauma.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1530-4515 1534-4908
DOI:	10.1097/SLE.0000000000000014