Robotic Ivor-Lewis esophagectomy for distal esophageal and esophagogastric junction cancer: A prospective study

2020 ◽  
Vol 46 (12) ◽  
pp. e7
Author(s):  
G. Pallabazzer ◽  
M. Belluomini ◽  
S. D''Imporzano ◽  
B. Solito ◽  
S. Santi
Keyword(s):  
Prospective Study ◽  
Esophagogastric Junction ◽  
Ivor Lewis ◽  
Ivor Lewis Esophagectomy ◽  
Esophagogastric Junction Cancer ◽  
A Prospective Study

477 MINIMALLY INVASIVE MEDIASTINOSCOPIC IVOR-LEWIS ESOPHAGECTOMY WITH CERVICAL ANASTOMOSIS FOR ESOPHAGOGASTRIC JUNCTION ADENOCARCINOMA PATIENT UNDER INTRAOPERATIVE RECURRENT LARYNGEAL NERVE MONITORING

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Akihiro Suzuki ◽  
Kazuhiko Mori ◽  
Shuntaro Hirose ◽  
Jo Tashiro ◽  
Taketo Matsubara ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Recurrent Laryngeal Nerve ◽  
Esophagogastric Junction ◽  
Laryngeal Nerve ◽  
Cervical Anastomosis ◽  
Nerve Monitoring ◽  
Ivor Lewis ◽  
Less Invasive ◽  
Ivor Lewis Esophagectomy ◽  
Made In

Abstract   In early 2000s, cervical anastomosis after esophagectomy was associated with a higher rate of recurrent nerve trauma than thoracic anastomosis. Recently, new technologies have been developed that reduce surgical complications. Mediastinoscopic esophagectomy is reportedly less invasive and allows faster recovery than thoracoscopic esophagectomy. Intraoperative nerve monitoring (IONM) prevents recurrent laryngeal nerve (RNL) palsy. We present the case of minimally invasive mediastinoscopic Ivor-Lewis Esophagectomy (MMIE) under IONM performed on an elderly esophagogastric junction (EGJ) adenocarcinoma patient. Methods An 84-year old man was consulted for adenocarcinoma of GEJ without lymphnode metastasis. Despite his advanced age, he had no comorbidities. We planned to perform MMIE under IONM. The procedure started with a patient lithotomy, and three trocars plus small incision were made in the upper abdomen. Celiac lymphadenectomy was performed. Subsequently, a 35 mm incision was made in the left side of the neck and a monitor was attached to left vagus nerve. Three trocars were placed with single incision surgical devices and pneumomediastinum was noticed. Mediastinoscopic esophagectomy was performed. Gastric tube reconstruction via mediastinum with cervical anastomosis was performed. Results The operation was successful. Total operation time was 393 minutes, with an estimated blood loss of 5 mL. There were no intraoperative and postoperative complications, and no RLN palsy occurred. Conclusion MMIE with cervical anastomosis under IONM is safe and less invasive especially for the respiratory system as a thoracotomy is unnecessary. Video https://www.dropbox.com/s/9yqkzg3pm619pf6/%E7%B8%A6%E9%9A%94%E9%8F%A12%E5%88%8656%E7%A7%92.mp4?dl=0.

scholarly journals Laparoscopic and left thoracoscopic Ivor-Lewis esophagectomy for Siewert type II esophagogastric junction cancer with right aortic arch: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Motoki Murakami ◽  
Yasutaka Nakanishi ◽  
Yudai Hojo ◽  
Tatsuro Nakamura ◽  
Tsutomu Kumamoto ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Esophagogastric Junction ◽  
Right Aortic Arch ◽  
Type Ii ◽  
Siewert Type ◽  
Ivor Lewis ◽  
Siewert Type Ii ◽  
Ivor Lewis Esophagectomy ◽  
Lateral Decubitus ◽  
The Right

Abstract Background Right aortic arch (RAA) is a congenital malformation detected in 0.04% of the population without heterotaxia and makes esophagectomy and mediastinal lymphadenectomy difficult. A left thoracic approach is recommended in patients with RAA, but a minimally invasive procedure has not yet been established. Case presentation The case was a 40-year-old man with RAA and Siewert type II adenocarcinoma of the esophagogastric junction with metastases to the adrenal glands and paraaortic lymph nodes. Conversion surgery was performed when radiologic disappearance of metastatic disease was confirmed after first-line treatment consisting of 12 cycles of S-1 plus platinum-based systemic chemotherapy. Minimally invasive laparoscopic and left thoracoscopic Ivor-Lewis esophagectomy was performed in the right semi-lateral decubitus position. The esophagus was easy to see on left thoracoscopy because of the RAA. Esophagectomy with lower mediastinal lymphadenectomy and an intrathoracic esophagogastric anastomosis was performed successfully with laparoscopy and thoracoscopy without a position change. There were no surgical complications, and no residual cancer was detected in the resected specimen on pathological examination. There has been no recurrence during 21 months of follow-up. Conclusions Laparoscopic and left thoracoscopic Ivor-Lewis esophagectomy in the right semi-lateral decubitus position is a minimally invasive, anatomically novel procedure for Siewert type II esophagogastric junction cancer in patients with RAA.

scholarly journals Intrathoracic Anastomosis or Cervical Anastomosis for Esophagogastric Junction Cancer Surgery: A Retrospective Cohort Study

2020 ◽  
Vol 104 (3-4) ◽  
pp. 123-130
Author(s):  
Kei Hosoda ◽  
Keishi Yamashita ◽  
Hiromitsu Moriya ◽  
Hiroaki Mieno ◽  
Masahiko Watanabe
Keyword(s):  
Reflux Esophagitis ◽  
Esophagogastric Junction ◽  
Survival Rates ◽  
Cervical Anastomosis ◽  
Ivor Lewis ◽  
Esophagogastric Junction Cancer ◽  
Study Population ◽  
Esophageal Invasion ◽  
Mckeown Esophagectomy ◽  
Esophagogastric Junction Carcinoma

Aims: This study aimed to determine the degree of reflux esophagitis after either intrathoracic or cervical esophagogastrostomy in patients with esophagogastric junction carcinoma. Patients and Methods: The study population consisted of 10 and 15 consecutive patients who underwent esophagectomy with gastric conduit reconstruction via intrathoracic (Ivor Lewis) or cervical (McKeown) esophagogastrostomy, respectively. Reflux esophagitis was evaluated annually after surgery and scored on a 0- to 4-point scale corresponding to grades N/M, A, B, C, and D, respectively. The reflux esophagitis score of each patient, defined as the average of scores at 1, 2, and 3 years after surgery, was compared between the groups. Results: Of the 30 planned annual endoscopic follow-ups (3 years in 10 patients) in the Ivor Lewis group and 45 planned follow-ups (3 years in 15 patients) in the McKeown group, 24 and 29 such follow-ups were performed in the Ivor Lewis and McKeown groups, respectively. The reflux esophagitis score was significantly better in the McKeown group than in the Ivor Lewis group (0.51 ± 0.24 versus 1.46 ± 0.29, P = 0.019). Overall survival did not significantly differ between the Ivor Lewis and McKeown groups (respective 5-year survival rates, 64% versus 57%, P = 0.75). Conclusions: The degree of reflux esophagitis may be greater in patients with esophagogastric junction cancer treated by Ivor Lewis esophagectomy than in those treated by McKeown esophagectomy. McKeown esophagectomy might be a more suitable method for the treatment of esophagogastric junction cancer with extended esophageal invasion.

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