scholarly journals Intrathoracic Esophagogastric Anastomosis Using a Linear Stapler Following Minimally Invasive Esophagectomy in the Prone Position

2012 ◽  
Vol 17 (2) ◽  
pp. 397-402 ◽  
Author(s):  
Hiroshi Okabe ◽  
Eiji Tanaka ◽  
Shigeru Tsunoda ◽  
Kazutaka Obama ◽  
Yoshiharu Sakai
Keyword(s):  
Minimally Invasive ◽  
Prone Position ◽  
Minimally Invasive Esophagectomy ◽  
Esophagogastric Anastomosis ◽  
Linear Stapler ◽  
Invasive Esophagectomy

Intrathoracic hand-sewn esophagogastric anastomosis in prone position during totally minimally invasive two-stage esophagectomy for esophageal cancer

2020 ◽  
Author(s):  
Alexandros Charalabopoulos ◽  
Spyridon Davakis ◽  
Athanasios Syllaios ◽  
Bruno Lorenzi
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Anastomotic Leak ◽  
Prone Position ◽  
Minimally Invasive Esophagectomy ◽  
Esophagogastric Anastomosis ◽  
Two Stage ◽  
End Points ◽  
Intrathoracic Anastomosis ◽  
Invasive Esophagectomy

Summary Utilization of totally minimally invasive esophagectomy for cancer is on the rise. Esophagogastric anastomosis is mechanically or robotically performed routinely; little report exists of hand-sewn esophagogastric anastomosis. This is the largest so far study with thoracoscopic hand-sewn esophagogastric anastomosis during fully minimally invasive two-stage esophagectomy for esophageal cancer in prone position. Consecutive two-stage totally minimally invasive esophagectomies for cancer were performed by one surgical team, from September 2016 to March 2019. All operations were technically identical in terms of patient positioning, surgical approach, extend of lymphadenectomy and type of anastomosis formed. Primary end points were anastomotic leak and anastomotic stricture rate, while secondary end points were 30-day and 90-day mortality rates. From the overall n = 80 patients, n = 67 were males, while n = 13 were females. Mean age was 64.6 years. Mean length of stay was n = 14 days. There were no conversions to open. Mean operating time was 420 minutes with no blood loss over 200 mL noted. Pulmonary and cardiac complication rate was 23.75% and 2.5%, respectively. Anastomotic leak rate was 2.5%. Anastomotic strictures were seen in 12.5% of cases. 30-day and 90-day mortality rate was 2.5% and 5%, respectively, with none accounted for ischemic conduit complications. Intrathoracic anastomosis in totally minimally invasive esophagectomy is challenging and accountable for most of the mortality associated with the procedure. In thoracoscopic two-stage esophagectomy, a mechanical anastomosis is usually preferred; this is believed to be due to the complexity of manual anastomosis associated with the thoracoscopic approach. We aim to present our series of completely hand-sewn intrathoracic anastomosis utilizing a totally minimally invasive approach with favorable outcomes. With this study, reproducibility of the anastomosis is shown that can potentially favor a change in the practice of esophageal surgeons worldwide.

384 SHORT-TERM OUTCOMES OF INTRA-THORACIC ESOPHAGO-GASTRIC ANASTOMOSES UNDER MINIMALLY INVASIVE ESOPHAGECTOMY VIA A PRONE POSITION

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Shinji Mine ◽  
Masayuki Watanabe ◽  
Atushi Kanamori ◽  
Yu Imamura ◽  
Akihiko Okamura ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Anastomotic Stricture ◽  
Minimally Invasive Esophagectomy ◽  
Anterior Wall ◽  
Gastric Conduit ◽  
Linear Stapler ◽  
Short Term ◽  
Invasive Esophagectomy ◽  
Operative Complications ◽  
Gastric Anastomosis

Abstract   Although minimally invasive esophagectomy (MIE) has been performed for esophageal cancer worldwide, intra-thoracic anastomosis under prone positions is still challenging. In this retrospective study, we reviewed our short-term results of this anastomotic technique in our institution. Methods From November 2016 to December 2019, we performed 319 esophagectomies. Of these patients, 28 patients (9%) underwent intra-thoracic esophago-gastric anastomosis under MIE. Procedures The left side of an esophageal stump which had been closed using a linear stapler was opened for anastomosis. Then, the anterior wall of a gastric conduit, around 5 cm below the tip, was opened for anastomosis. Linear staplers were inserted in both esophageal stump and gastric conduit and side-to-side anastomosis was performed. The opening for insertion was closed using a hand-sewn anastomosis in 2 layers. Results Five patients (18%) suffered anastomotic leakage with Clavien-Dindo 2 and 3a, and all of them recovered by conservative treatments. Two patients (2/19, 11%) showed anastomotic stricture which improved by several endoscopic dilatations. Six patients (6/19, 32%) showed the reflux esophagitis of Grade C. Conclusion Although we have not experienced severe or critical post-operative complications, the short-term results of intra-thoracic anastomosis under MIE were not sufficient. Additional progresses in techniques are required.

scholarly journals Minimally invasive esophagectomy: Preservation of arch of Azygos vein in prone position

2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Madhabananda Kar ◽  
Mohammed Imaduddin ◽  
DillipK Muduly ◽  
Mahesh Sultania ◽  
Tim Houghton ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Prone Position ◽  
Minimally Invasive Esophagectomy ◽  
Azygos Vein ◽  
Invasive Esophagectomy

scholarly journals Thoracic duct identification with indocyanine green fluorescence during minimally invasive esophagectomy with patient in prone position

2020 ◽  
Vol 33 (12) ◽  
Author(s):  
Massimo Vecchiato ◽  
Antonio Martino ◽  
Massimo Sponza ◽  
Alessandro Uzzau ◽  
Antonio Ziccarelli ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Indocyanine Green ◽  
Prone Position ◽  
Thoracic Duct ◽  
Minimally Invasive Esophagectomy ◽  
Standard Procedure ◽  
Transthoracic Esophagectomy ◽  
Green Fluorescence ◽  
Indocyanine Green Fluorescence ◽  
Invasive Esophagectomy

Abstract Chylothorax is a serious complication of transthoracic esophagectomy. Intraoperative thoracic duct (TD) identification represents a possible tool for preventing or repairing its lesions, and it is most of the time difficult, even during high-definition thoracoscopy. The aim of the study is to demonstrate the feasibility of using near-infrared fluorescence-guided thoracoscopy to identify TD anatomy and check its intraoperative lesions during minimally invasive esophagectomy. A 0.5 mg/kg solution of indocyanine green (ICG) was injected percutaneously in the inguinal nodes of 19 patients undergoing minimally invasive esophagectomy in a prone position, before thoracoscopy. TD anatomy and potential intraoperative lesions were checked with the KARL STORZ OPAL1® Technology. In all of the 19 patients where transthoracic esophagectomy was feasible, the TD was clearly identified after a mean of 52.7 minutes from injection time. The TD was cut for oncological radicality in two patients, and it was successfully ligated under the ICG guide. No postoperative chylothorax or adverse reactions from the ICG injection occurred. The TD identification with indocyanine green fluorescence during minimally invasive esophagectomy is a simple, effective, and non-time-demanding tool; it may become a standard procedure to prevent postoperative chylothorax.

T-shaped linear-stapled cervical esophagogastric anastomosis for minimally invasive esophagectomy: a pilot study

2020 ◽  
Vol 106 (6) ◽  
pp. 506-509 ◽  
Author(s):  
Xinju Li ◽  
Zhe Wang ◽  
Guangjian Zhang ◽  
Junke Fu ◽  
Qifei Wu
Keyword(s):  
Esophageal Cancer ◽  
Pilot Study ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Operation Time ◽  
Esophagogastric Anastomosis ◽  
Anastomotic Complications ◽  
Invasive Esophagectomy ◽  
Cervical Esophagogastric Anastomosis ◽  
A Minor

Background: Minimally invasive esophagectomy (MIE) has become a good option in the surgical treatment of esophageal cancer. Cervical esophagogastric anastomoses (CEGA) are widely used during esophagectomy. However, CEGA are related with a higher incidence of anastomotic complications. In the present study, a new procedure of T-shaped linear-stapled cervical esophagogastric anastomosis was used during MIE and the short-term outcomes are presented. Methods: From May 2014 to December 2018, 32 consecutive patients with esophageal cancer who underwent total MIE followed by T-shaped linear-stapled cervical esophagogastric anastomosis were included. Postoperative outcomes were analyzed. Results: Fifteen men and 17 women were included this pilot study. The histology of all cases was squamous cell carcinoma. Mean operation time of T-shaped linear-stapled cervical esophagogastric anastomosis was 17.6 minutes. There were no early or late mortalities. A minor cervical anastomotic leakage occurred in 1 patient. No complications of anastomotic stenosis occurred in this study. Conclusion: The T-shaped linear-stapled cervical esophagogastric anastomosis is efficient, reliable, easy to perform, and associated with lower postoperative complication rate.

scholarly journals Minimally invasive esophagectomy in the lateral-prone position: Experience of 124 cases in a single center

2017 ◽  
Vol 9 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Shaohua Ma ◽  
Tianshen Yan ◽  
Dandan Liu ◽  
Keyi Wang ◽  
Jingdi Wang ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Prone Position ◽  
Minimally Invasive Esophagectomy ◽  
Single Center ◽  
Invasive Esophagectomy

Technical and perioperative outcomes of minimally invasive esophagectomy in the prone position

2012 ◽  
Vol 27 (2) ◽  
pp. 553-557 ◽  
Author(s):  
Ross F. Goldberg ◽  
Steven P. Bowers ◽  
Michael Parker ◽  
John A. Stauffer ◽  
Horacio J. Asbun ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Prone Position ◽  
Minimally Invasive Esophagectomy ◽  
Perioperative Outcomes ◽  
Invasive Esophagectomy

Minimally invasive esophagectomy: thoracoscopic esophageal mobilization for esophageal cancer with the patient in prone position

2011 ◽  
Vol 26 (4) ◽  
pp. 1102-1107 ◽  
Author(s):  
Roberto Petri ◽  
Marco Zuccolo ◽  
Marco Brizzolari ◽  
Luca Rossit ◽  
Alessandro Rosignoli ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Prone Position ◽  
Minimally Invasive Esophagectomy ◽  
Invasive Esophagectomy

Minimally Invasive Esophagectomy in the Lateral-prone Position

2016 ◽  
Vol 26 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Xu Li ◽  
Fan-Cai Lai ◽  
Min-lian Qiu ◽  
Rong-gang Luo ◽  
Jian-bo Lin ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Prone Position ◽  
Minimally Invasive Esophagectomy ◽  
Invasive Esophagectomy
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