scholarly journals Comparison of short‐term outcomes following minimally invasive versus open Sweet esophagectomy for Siewert type II adenocarcinoma of the esophagogastric junction

2020 ◽  
Vol 11 (6) ◽  
pp. 1487-1494
Author(s):  
Xiaohui Sun ◽  
Gaoxiang Wang ◽  
Changqing Liu ◽  
Ran Xiong ◽  
Hanran Wu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Esophagogastric Junction ◽  
Type Ii ◽  
Short Term ◽  
Siewert Type ◽  
Siewert Type Ii

scholarly journals Short-Term Clinical Efficacy of Neoadjuvant Chemotherapy Combined With Laparoscopic Gastrectomy for Locally Advanced Siewert Type II and III Adenocarcinoma of the Esophagogastric Junction: A Retrospective, Propensity Score-Matched Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Qing Feng ◽  
Du Long ◽  
Ming-shan Du ◽  
Xiao-song Wang ◽  
Zhen-shun Li ◽  
...  
Keyword(s):  
Risk Factor ◽  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Esophagogastric Junction ◽  
Independent Risk Factor ◽  
Locally Advanced ◽  
Type Ii ◽  
Short Term ◽  
Siewert Type ◽  
Siewert Type Ii

BackgroundLaparoscopic gastrectomy (LG) has been increasingly used for the treatment of locally advanced Siewert type II and III adenocarcinoma of the esophagogastric junction (AEG). However, whether LG can achieve the same short-term efficacy in the treatment of patients who receive neoadjuvant chemotherapy (NACT) remains controversial. Thus, the aim of this study was to investigate the clinical outcomes of NACT combined with LG for Siewert type II and III AEG.MethodsThis retrospective study identified patients with locally advanced Siewert type II and III AEG diagnosed between May 2011 and October 2020 using the clinical tumor-node-metastasis (cTNM) staging system. The short-term outcomes were compared between the matched groups using a 1:3 propensity score matching (PSM) method, which was performed to reduce bias in patient selection.ResultsAfter PSM, 164 patients were selected, including 41 in the NACT group and 123 in the LG group. The baseline characteristics were similar between the two groups. Compared with the LG group, the NACT group exhibit a smaller tumor size and significantly less advanced pathological tumor classification and nodal classification stages. The time to first flatus of the NACT group was significantly shorter, but the hospital stay was significantly longer than that of the LG group. The NACT group showed similar overall (29.3% vs 25.2%, P=0.683), systemic (24.4% vs 21.1%, P=0.663), local (12.2% vs 9.8%, P=0.767), minor (19.5% vs 19.5%, P=1.000) and major (9.8% vs 5.7%, P=0.470) complications as the LG group. Subgroup analyses showed no significant differences in most stratified parameters. Operation time≥ 300 minutes was identified as an independent risk factor for overall complications. Age≥ 60 years was identified as an independent risk factor for major complications.ConclusionNACT combined with LG for AEG does not increase the risk of postoperative morbidity and mortality compared with LG.

Short-term outcomes after laparoscopic versus open transhiatal resection of Siewert type II adenocarcinoma of the esophagogastric junction

2017 ◽  
Vol 32 (1) ◽  
pp. 383-390 ◽  
Author(s):  
Shizuki Sugita ◽  
Takahiro Kinoshita ◽  
Akio Kaito ◽  
Masahiro Watanabe ◽  
Hideki Sunagawa
Keyword(s):  
Esophagogastric Junction ◽  
Type Ii ◽  
Short Term ◽  
Siewert Type ◽  
Siewert Type Ii

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 Proximal Gastrectomy versus Total Gastrectomy for Siewert Type II Adenocarcinoma of the Esophagogastric Junction: A Comprehensive Analysis of Data from the SEER Registry

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Kaixuan Zhu ◽  
Yingying Xu ◽  
Jiaxin Fu ◽  
Farah Abdidahir Mohamud ◽  
Zongkui Duan ◽  
...  
Keyword(s):  
Total Gastrectomy ◽  
Surgical Approach ◽  
Esophagogastric Junction ◽  
Proximal Gastrectomy ◽  
Locally Advanced ◽  
Cox Proportional Hazards Model ◽  
Type Ii ◽  
Siewert Type ◽  
Siewert Type Ii ◽  
Significant Difference

Background. To determine the ideal surgical approach (total gastrectomy (TG) vs. proximal gastrectomy (PG)) for Siewert type II adenocarcinoma of the esophagogastric junction (AEG), we searched and analyzed the Surveillance, Epidemiology, and End Results (SEER) data. Methods. Patients with Siewert type II AEG treated by TG or PG were identified from the 2004–2014 SEER dataset. We obtained the patients’ overall survival (OS) and cancer-specific survival (CSS) and stratified the patients by surgical approach. We performed a propensity score 1 : 1 matching (PSM) analysis and a univariate and multivariate Cox proportional hazards model. Results. A total of 2,217 patients with 6th AJCC stage IA–IIIB Siewert type II AEG was examined: 1,584 patients (71.4%) underwent PG, and 633 patients (28.6%) underwent TG. The follow-up time was 1–131 months. OS favored total gastrectomy before the PSM analysis (χ2=3.952, p=0.047), but after this analysis, there was no significant difference between TG and PG (χ2=2.227, p=0.136). The univariate and multivariate analyses identified age as an independent factor, and an X-tail analysis revealed 70 years as a cut-off point. The patients aged≥70 years obtained a significant long-term OS benefit from PG compared to TG (χ2=8.245, p=0.004), and those aged<70 years showed no difference between TG and PG (χ2=0.167, p=0.682). Conclusions. PG showed an equivalent survival benefit to TG in both the early and locally advanced stages of Siewert type II AEG. For elderly patients, PG is strongly recommended because of its clearer OS benefit compared to TG.

scholarly journals Novel abdominal approach for dissection of advanced type II/III adenocarcinoma of the esophagogastric junction: a new surgical option

2018 ◽  
Vol 47 (1) ◽  
pp. 398-410 ◽  
Author(s):  
Can Hu ◽  
Hao-te Zhu ◽  
Zhi-yuan Xu ◽  
Jian-fa Yu ◽  
Yi-an Du ◽  
...  
Keyword(s):  
Lymph Node ◽  
Survival Rate ◽  
Postoperative Complications ◽  
Total Gastrectomy ◽  
Surgical Approach ◽  
Esophagogastric Junction ◽  
Abdominal Cavity ◽  
Type Ii ◽  
Siewert Type ◽  
Siewert Type Ii

Objective The optimal surgical approach for Siewert type II adenocarcinoma of the esophagogastric junction (AEG) is controversial. In this study, we evaluated the outcomes of total gastrectomy for Siewert type II/III AEG via the left thoracic surgical approach that is used at our center. Methods We identified 41 patients with advanced AEG in our retrospective database and analyzed their 3-year survival rate, upper surgical margin, postoperative complications, and index of estimated benefit from lymph node dissection. Results The 3-year overall survival rate of the whole group was 63%, but no difference was observed between Siewert type II and III AEGs. Esophageal exposure and lymphadenectomy were sufficient. Eight patients developed postoperative complications, but none of the patients developed anastomotic leakage. Dissection of lymph node station Nos. 19 and 110 may be necessary for patients with Siewert type II AEG. Multivariate analysis revealed that the cT category was the only independent risk factor. Conclusions Total gastrectomy via an approach from the abdominal cavity into the thoracic cavity may be an optimal surgical technique for advanced Siewert type II AEG.

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