scholarly journals USE OF PEG SITE FOR SPECIMEN RETRIEVAL AND EXTRACORPOREAL GASTRIC CONDUIT FORMATION, IN MINIMALLY INVASIVE ESOPHAGECTOMY

2016 ◽  
Vol 2 (1) ◽  
Author(s):  
Misbah Khan ◽  
Namra Urooj ◽  
Aamir A Syed ◽  
Shahid Khattak ◽  
Anam Muzzafar ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Oesophageal Cancer ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Operative Time ◽  
Gastric Conduit ◽  
Wound Complications ◽  
Excision Biopsy ◽  
Endoscopic Gastrostomy ◽  
Specimen Retrieval ◽  
Minimally Invasive Oesophagectomy

Purpose: Purpose of the present study is to report our technique of the use of percutaneous endoscopic gastrostomy (PEG) site excision biopsy wound, for specimen retrieval and gastric conduit formation, in minimally invasive oesophagectomy for oesophageal cancer.Methods: It is a retrospective comparative study where we present data of our 100 resectable oesophageal cancer patients who underwent postneoadjuvant minimally invasive oesophagectomy from January 2012 to September 2015. All of the patients had an initial staging endoscopic ultrasound with PEG placement. The prestudy (conventional) approach, i.e., laparoscopic gastric conduit formation along with specimen pull up from the cervical/thoracic wound is compared to the present (Study) group.Results: The two groups were similar for basic demographic variables, tumour stage, morphology and nutritional status. The primary endpoints were an operative time in minutes and any additional procedure-speci c complications. The rate of procedure speci c complications (Abdominal excision wound complications or conduit failure) was low 11%. PEG site excision biopsy was positive in two cases; one adenocarcinoma and one squamous carcinoma, both were mid to lower oesophageal tumours not involving gastroesophageal junction.Conclusions: Bene ts of the approach are ease of gastric conduit formation along with an additional second layer with less operative time through the small wound, avoidance of tumour specimen removal all the way through mediastinum from the cervical incision, and excision of a potential site of oesophageal cancer metastasis, without any added morbidity.Key words: Extracorporeal gastric conduit, minimally invasive oesophagectomy, percutaneous endoscopic gastrostomy

Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy: Its Role in Providing Enteric Access when Percutaneous Endoscopic Gastrostomy is not Possible

2006 ◽  
Vol 72 (12) ◽  
pp. 1222-1224 ◽  
Author(s):  
Randal L. Croshaw ◽  
James M. Nottingham
Keyword(s):  
General Anesthesia ◽  
Patient Care ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Wound Complications ◽  
Unsuccessful Attempt ◽  
Endoscopic Gastrostomy ◽  
Laparoscopic Gastrostomy ◽  
Laparoscopic Assisted ◽  
Surgical Gastrostomy ◽  
Percutaneous Radiologic Gastrostomy

Percutaneous endoscopic gastrostomy (PEG) replaced open surgical gastrostomy (OSG) as the preferred method for enteric access soon after its introduction in 1980.1 Since that time, laparoscopic gastrostomy (LG), percutaneous radiologic gastrostomy (PRG), and laparoscopic-assisted PEG (LAPEG) have been introduced. PEG and PRG have been found to be over 95 per cent successful, convenient, economical, and associated with less morbidity than OSG.2, 3 However, there are patients that are not appropriate candidates for, or have failed attempts at, PEG or PRG placement. At one time, OSG was the only option left for these patients, but they may be better served by LAPEG or, in some cases, LG. LAPEG offers less morbidity than OSG by having less pain and wound complications, and potentially may avoid the use of general anesthesia.4–6 We present a series of patients that underwent successful LAPEG placement after an unsuccessful attempt at PEG placement, and we describe its role in patient care.

Surgical optimisation of the gastric conduit for minimally invasive oesophagectomy

2011 ◽  
Vol 26 (1) ◽  
pp. 271-276 ◽  
Author(s):  
Shahjehan A. Wajed ◽  
Darmarajah Veeramootoo ◽  
Angela C. Shore
Keyword(s):  
Minimally Invasive ◽  
Gastric Conduit ◽  
Minimally Invasive Oesophagectomy

PS01.241: HYBRID MINIMALLY INVASIVE TECHNIQUE OF OESOPHAGECTOMY FOR OESOPHAGEAL CARCINOMA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 118-118
Author(s):  
Satpal Virk ◽  
Saurabh Singla
Keyword(s):  
Postoperative Complications ◽  
Minimally Invasive ◽  
Oesophageal Cancer ◽  
Gastric Tube ◽  
Operative Time ◽  
Laparoscopic Group ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Open Technique ◽  
Open Procedure

Abstract Background Oesophagectomy is challenging procedure involving multiple body cavities. The traditional open procedure being either transthoracic or transhiatal, carries significant morbidity and mortality. There is continuing debate between the two approaches. Minimally invasive oesophagectomy has swung the pendulum towards transthoracic procedure, though it remains a complex and technically demanding procedure. This study was done to assess the feasibility, and benefit of hybrid minimally invasive technique over open technique. Methods Patients of oesophageal cancer were selected from January 2005 to December 20,017. After 2012 open technique was replaced with minimally invasive technique. Open technique included Ivor Lewis, McKeown's or transhiatal. Hybrid minimally invasive technique included laparoscopic gastric mobilisation and thoracic part using small thoracotomy. Anastomosis was done using hand sewn technique. The short term outcome, including postoperative complications were analysed from prospectively collected data. Results One hundred sixty three patients underwent open procedure and 103 patients underwent hybrid minimally invasive esophagectomy. Total operative time was shorter in laparoscopic group (325.6 minutes vs 232.6 minutes, P < 0.05). The number of transfused patients were significantly smaller in laparoscopic group (40.75% vs 13.6%, P < 0.05). The postoperative course without complication was observed in 68.1% and 79.3% in open vs laparoscopic group respectively. Serious complications included myocardial infarction and gastric tube necrosis and bleed. There was no anastomotic leak in chest anastomosis but there was overall 17.3% leak in neck anastomosis, higher in open group 20.8% vs 16.6% in minimally invasive group. Mortality was higher ion open group (5.5% vs 2%, P < 0.05). On multivariate analysis, age more than 60 years, chest complications and cardiovascular comorbidity were associated with increased mortality. Conclusion Hybrid minimally invasive procedure is feasible and safe procedure for patients with oesophageal cancer. it is associated with shorter operative time and less postoperative complications. Even laparoscopic gastric tube mobilisation alone adds to in decreasing the morbidity in esophagectomy. Disclosure All authors have declared no conflicts of interest.

scholarly journals Robotic-assisted single-incision gastric mobilization for minimally invasive oesophagectomy for oesophageal cancer: preliminary results

2020 ◽  
Vol 58 (Supplement_1) ◽  
pp. i65-i69
Author(s):  
Yu-Han Huang ◽  
Ke-Cheng Chen ◽  
Sian-Han Lin ◽  
Pei-Ming Huang ◽  
Pei-Wen Yang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Minimally Invasive ◽  
Lymph Node Dissection ◽  
Oesophageal Cancer ◽  
Single Incision ◽  
Single Port ◽  
Node Dissection ◽  
Abdominal Lymph Node ◽  
Robotic Assisted ◽  
Minimally Invasive Oesophagectomy

Abstract OBJECTIVES With the gradual acceptance of robotic-assisted surgery to treat oesophageal cancer and the application of a single-port approach in several abdominal procedures, we adopted a single-port technique in robotic-assisted minimally invasive oesophagectomy during the abdominal phase for gastric mobilization and abdominal lymph node dissection. METHODS Robotic-assisted oesophagectomy and mediastinal lymph node dissection in the chest were followed by robotic-assisted gastric mobilization and conduit creation with abdominal lymph node dissection, which were performed via a periumbilicus single incision. The oesophagogastrostomy was accomplished either in the chest (Ivor Lewis procedure) or neck (McKeown procedure) depending on the status of the proximal resection margin. RESULTS The procedure was successfully performed on 11 patients with oesophageal cancer from January 2017 to December 2018 in our institute. No surgical or in-hospital deaths occurred, though we had one case each of anastomotic leakage, pneumonia and hiatal hernia (9%). CONCLUSIONS Robotic single-incision gastric mobilization for minimally invasive oesophagectomy for treating oesophageal cancer seems feasible. Its value in terms of perioperative outcome and long-term survival results awaits future evaluation.

Hybrid minimally invasive versus open oesophagectomy for patients with oesophageal cancer: A multicenter, open-label, randomized phase III controlled trial, the MIRO trial.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 5-5 ◽  
Author(s):  
Christophe Mariette ◽  
Bernard Meunier ◽  
Denis Pezet ◽  
Cecile Dalban ◽  
Denis Collet ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Oesophageal Cancer ◽  
Postoperative Morbidity ◽  
Controlled Trial ◽  
Pulmonary Complications ◽  
Phase Iii ◽  
Open Label ◽  
Intention To Treat ◽  
Randomised Controlled ◽  
Minimally Invasive Oesophagectomy

5 Background: Surgical resection is regarded as the only curative option for resectable oesophageal cancer. Postoperative morbidity, in particular pulmonary complications, continues to be of great concern and occurs in more than half of patients after open oesophagectomy (OO). We assessed whether hybrid minimally invasive oesophagectomy (HMIO) reduces morbidity compared with OO. Methods: We performed a multicentre, open-label, randomised controlled trial at 12 study centres between October 2009 and April 2012. Patients aged 18-75 years old with resectable cancers of the middle or lower third of the oesophagus were assigned by a computer-generated randomisation sequence to undergo either transthoracic OO or HMIO. Surgical technique was standardised by both on site visits and the use of videos, and was based on an Ivor Lewis procedure with laparoscopic gastric mobilisation and open right thoracotomy. Randomisation was stratified by centre. The primary outcome was 30 day grade II-IV postoperative morbidity as defined by the Dindo-Clavien classification. Analysis was by intention to treat. Results: We randomly assigned 104 patients to the OO group and 103 to the HMIO group. Sixty-seven (64.4%) patients in the OO group had major postoperative morbidity compared with 37 (35.9%) in the HMIO group (OR 0·31, 95% CI 0·18-0·55; p=0·0001). Thirty-one (30.1%) patients in the OO had major pulmonary complications compared with 18 (17.7%) in the minimally invasive group p=0·037), whereas 30-day mortality was 5 (4.9%) vs. 5 (4.9%), respectively. Conclusions: These findings provide evidence for the short-term benefits of HMIO for patients with resectable oesophageal cancer (NCT00937456 ClinicalTrials.gov). Clinical trial information: NCT00937456.

scholarly journals A Silent and Chronic Complication of Percutaneous Endoscopic Gastrostomy Tube: Small Bowel Enterocutaneous Fistula

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Sai Wah Cheung
Keyword(s):  
Small Bowel ◽  
Minimally Invasive ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Enterocutaneous Fistula ◽  
Major Complication ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Delay In Diagnosis ◽  
Endoscopic Gastrostomy ◽  
Chronic Complication ◽  
Lower Morbidity

Percutaneous endoscopic gastrostomy (PEG) has gradually gained the popularity since its invention and become the most preferred method for gastrostomy insertion in recent years. PEG is associated with lower morbidity and mortality and has the advantages of being minimally invasive and more convenient over the conventional open gastrostomy. However, significant rates of major complication still occur. Enterocutaneous fistula is one of the key complications that can be easily neglected due to its asymptomatic nature. We present a case of small bowel enterocutaneous fistula which was only found 8 years after the PEG insertion, being diagnosed after the longest duration of delay in diagnosis reported in literature.

Sign in / Sign up

Export Citation Format

Share Document