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.

Minimally Invasive Esophagectomy with Right Bronchial Occlusion under Artificial Pneumothorax

2015 ◽  
Vol 32 (2) ◽  
pp. 77-81 ◽  
Author(s):  
Yi Zhang ◽  
RuiHua Duan ◽  
XiangFeng Xiao ◽  
Tiecheng Pan
Keyword(s):  
Minimally Invasive ◽  
Esophageal Carcinoma ◽  
Prone Position ◽  
Operative Time ◽  
Minimally Invasive Esophagectomy ◽  
Subtotal Esophagectomy ◽  
Invasive Esophagectomy ◽  
Artificial Pneumothorax ◽  
Average Operative Time ◽  
The Right

Aims: To assess the safety and feasibility of minimally invasive esophagectomy and selected three-field lymphadenectomy with the right bronchial occlusion in left semi-prone position under artificial pneumothorax. Methods: Thoracoscopic-laparoscopic subtotal esophagectomy and selected three-field lymphadenectomy were performed in 166 patients with esophageal carcinoma by the right bronchial occlusion in left semi-prone position under artificial pneumothorax. Results: 109 patients received two-field lymphadenectomy and 57 received three-field lymphadenectomy. The average operative time was 202.5 ± 21.3 min; the average thoracoscopic operative time was 98.4 ± 15.5 min. The average blood loss was 39.6 ± 4.2 ml, and no blood transfusion was needed during the surgery. The mean lymph node harvest was 28.4 ± 5.2 nodes. Hospital stay ranged from 7 to 95 days and the average was 11.3 days. The postoperative complication rate was 29.5%, and the mortality rate was 1.2%. Conclusions: It is feasible and safe to perform thoracoscopic-laparoscopic subtotal esophagectomy and selected three-field lymphadenectomy with the right bronchial occlusion in left semi-prone position under artificial pneumothorax for esophageal carcinoma. The procedure shows advantages in improved visibility and accessibility of the surgical field, and better subsequent surgical outcomes.

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 TOTALLY MINIMALLY INVASIVE ESOPHAGECTOMY 3D HD FOR THORACIC ESOPHAGEAL CANCER AFTER NEOADJUVANT CHEMORADIOTHERAPY

2018 ◽  
Vol 5 (3) ◽  
pp. 133-146
Author(s):  
F. Achim ◽  
M. Gheorghe ◽  
A. Constantin ◽  
P. Hoara ◽  
C. Popa ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Technology ◽  
Morbidity And Mortality ◽  
Esophageal Reconstruction ◽  
Thoracic Esophageal Cancer ◽  
Invasive Esophagectomy

Esophagectomy is a major surgical procedure with morbidity, and mortality related to the patient'scondition, stage of the disease at the moment of diagnosis, complementary treatments and surgicalexperience of the surgeon. Minimally invasive esophagectomy (MIE) may lead to a reduction inperioperative morbidity and mortality with an acceptable quality of life and similar oncologic resultsto an open approach. We present an experience of the Center of Excellence in Esophageal Surgeryregarding totally MIE through thoracolaparoscopic modified McKeown triple approach, followedby esophageal reconstruction by gastric intrathoracic pull-up and cervical esophagogastricanastomosis and feeding jejunostomy in a patient with thoracic esophageal cancer who underwentpreoperative neoadjuvant chemoradiotherapy. The short-term outcomes of the totally minimallyinvasive esophagectomy procedure were very encouraging. The overall operative times were:thoracoscopic - 120 minutes, laparoscopic - 130 minutes and cervical - 50 minutes with a total of360 minutes. The intraoperative blood loss was 200 ml. The postoperative outcome was favorablewith early feeding on the jejunostomy. The control of cervical anastomosis was performed in the 6thday postoperative and the patient was discharged in the 10th day postoperative without anysymptomatology. At the first and third-month follow-up was not reported any postoperativecomplications. The totally minimally invasive approach using advanced technology of endoscopicsurgery allowed for this patient a simple postoperative evolution, no major complications and agood recovery after extensive surgery. The solid experience in open esophageal surgery ofUpper Gastro-Intestinal surgeons provides a fast learning curve of complex minimally invasivesurgical procedures with reduced perioperative morbidity. Long-term follow-up can confirm theresults from the literature regarding the survival, which is expected to be for these patients atleast equivalent with outcomes after open esophagectomy.

Totally Minimally Invasive Esophagectomy and Gastric Pull-Up Reconstruction with an Intrathoracic Circular Stapled Anastomosis with a Team of Two (Surgeon and Assistant Only)

2017 ◽  
Vol 66 (05) ◽  
pp. 401-403 ◽  
Author(s):  
Hauke Lang ◽  
Peter Grimminger
Keyword(s):  
Quality Of Life ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Laparoscopic Approach ◽  
Esophageal Surgery ◽  
Operative Trauma ◽  
Robotic Assisted ◽  
Invasive Esophagectomy ◽  
Gastric Pull Up

AbstractTotally minimally invasive esophagectomy (MIE) is nowadays en vogue.1 2 3 4 5 There are several reports showing that already partial minimally invasive esophagectomies (hybrid esophagectomies) with a laparoscopic approach and open transthoracic resection are beneficial for patients due to the reduced operative trauma. Also for total MIE several groups have reported benefits for patients in terms of morbidity and quality of life.1 5 However, different approaches and experiences of different esophageal surgery groups are hardly comparable and thus do not allow a simple answer in favor of a specific total MIE technique. To enlighten the field of total MIE, we present the technique as we perform this procedure nearly weekly in our department. The described MIE technique is safe and feasible. Changing to this demonstrating technique, we did not have any mortality so far, even in the first 30 cases. Especially for surgeons who plan to switch from the open surgical technique toward hybrid, MIE or robotic-assisted MIE.

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