scholarly journals Value of enhanced recovery after surgery in perioperative period of minimally invasive esophagectomy for esophageal carcinoma

2017 ◽  
Vol 25 (16) ◽  
pp. 1491 ◽  
Author(s):  
Fa-Yu Ling ◽  
Jian-Wen Xiong ◽  
Dong-Liang Yu ◽  
Yi-Ping Wei ◽  
Jian-Jun Xu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Esophageal Carcinoma ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Minimally Invasive Esophagectomy ◽  
Perioperative Period ◽  
Invasive Esophagectomy

scholarly journals Impact of nasogastric decompression on gastric tube size after McKeown minimally invasive esophagectomy: A retrospective controlled cohort study

2021 ◽  
Author(s):  
Duo Jiang ◽  
Xian-Ben Liu ◽  
Wen-Qun Xing ◽  
Pei-Nan Chen ◽  
Shao-Kang Feng ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Gastric Tube ◽  
Enhanced Recovery ◽  
Minimally Invasive Esophagectomy ◽  
Tube Size ◽  
Invasive Esophagectomy ◽  
Chest X Ray ◽  
The Right ◽  
The Impact ◽  
Nasogastric Decompression

Abstract Purpose: This retrospective study evaluated the impact of nasogastric decompression (NGD) on gastric tube size to optimize the Enhanced Recovery After Surgery protocol after McKeown minimally invasive esophagectomy (MIE). Methods: Overall, 640 patients were divided into two groups according to nasogastric tube (NGT) placement intraoperatively. Using propensity score matching, 203 pairs of individuals were identified for gastric tube size comparisons on postoperative days (PODs) 1 and 5. Results: Gastric tubes were larger in the non-NGD group than the NGD group on POD 1 (vertical distance from the right edge of the gastric tube to the right edge of the thoracic vertebra, 22.2 [0–34.7] vs. 0 [0–22.5] mm, p <0.001). No difference was noted between the groups on POD 5 (18.5 [0–31.7] vs. 18.0 [0–25.4] mm, p =0.070). Univariate and multivariate analyses showed that non-NGD was an independent risk factor for gastric tube distention on POD 1. No difference in the incidence of complications (Clavien–Dindo（CD）≥2) (40 (23.0%) vs. 46 (19,8%), p =0.440), pneumonia (CD≥2) (29 [16.8%] vs. 30 [12.9%], p =0.280) or anastomotic leakage (CD≥3) (3 [1.7%] vs. 6 [2.6%], p =0.738) were noted between the without gastric tube distention group and with gastric tube distention group. Conclusion: Intraoperative NGT placement reduces gastric tube distention rates after McKeown MIE on POD 1, but the complications are similar to those of unconventional NGT placement. This finding is based on NGT placement or replacement at the appropriate time postoperatively through bedside chest X-ray examination.

Robotic-assisted minimally invasive esophagectomy for treatment of esophageal carcinoma

2016 ◽  
Vol 11 (2) ◽  
pp. 193-199 ◽  
Author(s):  
Philip W. Chiu ◽  
Anthony Y. Teoh ◽  
Vivien W. Wong ◽  
Hon Chi Yip ◽  
Shannon M. Chan ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Esophageal Carcinoma ◽  
Minimally Invasive Esophagectomy ◽  
Robotic Assisted ◽  
Invasive Esophagectomy

PS02.018: MINIMALLY INVASIVE ESOPHAGECTOMY (MIE): FROM HYBRID, TO FULLY MINIMALLY-INVASIVE (MIE) AND TO ROBOTIC ASSISTED MIE (RAMIE): A SINGLE SURGEON ANALYSIS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 125-125
Author(s):  
Evangelos Tagkalos ◽  
Edin Hadzijusufovic ◽  
Florian Matthias Corvinus ◽  
Benjamin Babic ◽  
Hauke Lang ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Lymph Nodes ◽  
Esophageal Carcinoma ◽  
Conflicts Of Interest ◽  
Minimally Invasive Esophagectomy ◽  
Demographic Data ◽  
Tumor Stage ◽  
Western World ◽  
Robotic Assisted ◽  
Invasive Esophagectomy

Abstract Background The incidence of esophageal carcinoma is increasing in the western world and esophageal resection is the essential therapy depending on the tumor stage. Several studies report advantages of minimally invasive esophagectomies (MIE) versus conventional open procedures. The use of totally MIE (thoraco- and laparoscopic) or robotic assisted MIE (RAMIE) compared to the hybrid approaches remain unclear. Methods Between July 2015 and August 2017, the data of 75 patients with esophageal carcinoma were prospectively registered. 25 were treated with a hybrid MIE (hybrid), another 25 with a totally MIE (MIE) and another 25 with a robotic assisted MIE (RAMIE). All patients were operated by the same specialized surgeon in our center. Demographic data), duration of total hospital- and intensive-care-stay (ICU), number of remote lymph nodes and histopathological R-status, as well as operating times were compared. The complications were assessed according to the Dindo-Clavien classification. Results The overall 30- and 90-day mortality rate were 0% and 1.33% (1/75) respectively. Hospital stay (P = 0.262), ICU stay (P = 0.079), number of resected lymph nodes (P = 0.863) and R status (P = 0.132) did not differ significantly between the groups. However more pneumonias and wound infections (P = 0.046 and P = 0.003 respectively) were found in the hybrid group when compared to the minimally invasive group (MIE und RAMIE). Conclusion Although the MIE as well as the RAMIE group contained the first 25 patients treated in this clinic with this procedures, comparable results with regard to oncological outcomes and morbidity could be achieved. Additionally the minimally invasive approaches seem to be assosiated with low occurence of pneumonia and wound infects. Disclosure All authors have declared no conflicts of interest.

scholarly journals MINIMALLY INVASIVE ESOPHAGECTOMY THROUGH MODIFIED MCKEOWN TRIPLE APPROACH WITH ESOPHAGEAL RECONSTRUCTION AND GASTRIC PULL-UP FOR THORACIC ESOPHAGEAL CARCINOMA

2016 ◽  
Vol 3 (2) ◽  
pp. 82-91
Author(s):  
Angelica Nicoleta Ionescu ◽  
Cristina Ghiță ◽  
Andreea Maria Stoean ◽  
I. F. Achim ◽  
A. Constantin ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Esophageal Carcinoma ◽  
Minimally Invasive Esophagectomy ◽  
Esophageal Reconstruction ◽  
Esophageal Tumor ◽  
Subtotal Esophagectomy ◽  
Invasive Esophagectomy ◽  
Thoracic Ct ◽  
Gastric Pull Up

We present the technique of triple approach minimally invasive subtotal esophagectomy: thoracoscopy, laparoscopy and left cervicotomy with gastric pull-up and cervical esogastric anastomosis in a 59 y.o patient. He was diagnosed with a middle thoracic esophageal tumor. The histologic report, thoracic CT and echoendoscopy confirmed the presence of scuamos esophageal carcinoma.

scholarly journals ENHANCED RECOVERY PATHWAYS (ERAS) IMPLEMENTATION IN MINIMALLY INVASIVE ESOPHAGECTOMY; AN EARLY EXPERIENCE

2021 ◽  
Vol 71 (6) ◽  
pp. 2082-86
Author(s):  
Aaishah Riaz ◽  
Bilal Umair ◽  
Asif Asghar ◽  
Muhammad Imtiaz ◽  
Raheel Khan ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hospital Stay ◽  
Enhanced Recovery ◽  
Minimally Invasive Esophagectomy ◽  
Postoperative Outcomes ◽  
Conventional Group ◽  
Invasive Esophagectomy ◽  
Icu Stay ◽  
Enhanced Recovery Pathways ◽  
Recovery Pathways

Objective: To evaluate the impact of enhanced recovery pathways (ERAS) on hospital stay and postoperative outcomes in patients undergoing minimally invasive esophagectomy in comparison to conventional pathway. Study Design: Quasi experimental study. Place and Duration of Study: Thoracic Surgery Department, Combined Military Hospital Rawalpindi Pakistan, from Jul 2018 to Mar 2020. Methodology: A total of 80 patients who underwent minimally invasive esophagectomy were divided in two groups. Group A underwent ERAS pathway and group B underwent conventional pathway. Both groups were compared for demographic characteristics, mean ICU stay, length of hospital stay, commencement of oral intake, and time of chest drain removal, readmission rates, postoperative morbidity and mortality. Results: There was no significant difference in age, gender and diagnostic indication among both groups. ERAS group was found to have shorter mean ICU stay (1.18 ± 0.55 vs 2.06 ± 1.10 days p<0.012), shorter hospital stay (7.50 ± 1.23 vs 11.6 ± 3.65 days, p<.001), earlier commencement of oral feeding (4.30 ± 1.41 vs 9.10 ± 4.26 days, p<0.001) and early removal of chest drains (3.22 ± vs 4.11 ± 1.52 p<0.001); when compared to conventional group. Overall morbidity in ERAS group was 50 (40%) versus 65% (81.25%) in conventional group. Mortality was same in both groups (2.5%). There was no readmission in ERAS group. Conclusion: ERAS in minimally invasive esophagectomy is safe and has positive impact on postoperative outcomes with marked reduction in overall morbidity in comparison to conventional regime. Results can be enhanced by ensuring better compliance to its.......

scholarly journals Risk Factors for Failure of Direct Oral Feeding following a Totally Minimally Invasive Esophagectomy

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3616
Author(s):  
Henricus J.B. Janssen ◽  
Amaia Gantxegi ◽  
Laura F.C. Fransen ◽  
Grard A.P. Nieuwenhuijzen ◽  
Misha D.P. Luyer
Keyword(s):  
Risk Factors ◽  
Minimally Invasive ◽  
Enhanced Recovery ◽  
Minimally Invasive Esophagectomy ◽  
Caloric Intake ◽  
Tube Feeding ◽  
Oral Feeding ◽  
Invasive Esophagectomy ◽  
Female Sex ◽  
Preoperative Risk Factors

Recently, it has been shown that directly starting oral feeding (DOF) from postoperative day one (POD1) after a totally minimally invasive Ivor-Lewis esophagectomy (MIE-IL) can further improve postoperative outcomes. However, in some patients, tube feeding by a preemptively placed jejunostomy is necessary. This single-center cohort study investigated risk factors associated with failure of DOF in patients that underwent a MIE-IL between October 2015 and April 2021. A total of 165 patients underwent a MIE-IL, in which DOF was implemented in the enhanced recovery after surgery program. Of these, 70.3% (n = 116) successfully followed the nutritional protocol. In patients in which tube feeding was needed (29.7%; n = 49), female sex (compared to male) (OR 3.5 (95% CI 1.5–8.1)) and higher ASA scores (III + IV versus II) (OR 2.2 (95% CI 1.0–4.8)) were independently associated with failure of DOF for any cause. In case of failure, this was either due to a postoperative complication (n = 31, 18.8%) or insufficient caloric intake on POD5 (n = 18, 10.9%). In the subgroup of patients with complications, higher ASA scores (OR 2.8 (95% CI 1.2–6.8)) and histological subtypes (squamous-cell carcinoma versus adenocarcinoma and undifferentiated) (OR 5.2 (95% CI 1.8–15.1)) were identified as independent risk factors. In the subgroup of patients with insufficient caloric intake, female sex was identified as a risk factor (OR 5.8 (95% CI 2.0–16.8)). Jejunostomy-related complications occurred in 17 patients (10.3%). In patients with preoperative risk factors, preemptively placing a jejunostomy may be considered to ensure that nutritional goals are met.

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