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Totally laparoscopic transhiatal esophago-gastrectomy without thoracic or cervical access: The least invasive surgery for adenocarcinoma of the cardia?

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Abstract

Background

The recent progress of minimally invasive surgery has allowed esophagectomy to be performed by both combined laparoscopic/thoracoscopic and totally laparoscopic transhiatal approaches. All these techniques imply a thoracic and/or cervical access for the creation of the esophagogastric anastomosis.

Methods

Five surgical ports are introduced in the abdomen. The stomach is mobilized, divided, and tubulized, preserving the right arteries. The lymphadenectomy of the celiac trunk and the hepatic pedicle is achieved. The dissection and resection of distal esophagus and a two-fields mediastinal lymphadenectomy are performed by means of harmonic scalpel. The realization of the intrathoracic esophago-gastrostomy is accomplished by means of a circular stapler.

Results

Three patients underwent the procedure. Mean operating time and blood loss were 347 min and 360 cc. There were no intraoperative or postoperative complications. Mean postoperative stay was 9 days.

Conclusion

In selected cases, it is possible to perform a distal esophagectomy entirely by laparoscopy, without the need for any thoracic or cervical access.

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References

  1. T Akaishi I Kaneda N Higuchi Y Kuriya J Kuramoto T Toyoda A Wakabayashi (1996) ArticleTitleThoracoscopic en bloc total esophagectomy with radical mediastinal lymphadenectomy. J Thorac Card Surg 112 1533–1540 Occurrence Handle1:STN:280:ByiC38bps10%3D

    CAS  Google Scholar 

  2. JS Azagra M Ceuterick M Goergen D Jacobs E Gilbart G Zaouk E Carlier P Lejeune JL Alle M Mathys (1993) ArticleTitleThoracoscopy in oesophagectomy for oesophageal cancer. Br J Surg 80 320–321 Occurrence Handle1:STN:280:ByyB3s%2FjvVw%3D Occurrence Handle8472139

    CAS  PubMed  Google Scholar 

  3. InstitutionalAuthorName. (1998) ArticleTitleClassification of adenocarcinoma of the oesophagogastric junction Br J Surg 85 1457–1459 Occurrence Handle1:STN:280:DyaK1M%2FjvFGjug%3D%3D Occurrence Handle9823902

    CAS  PubMed  Google Scholar 

  4. A Cuschieri S Shimi S Banting (1992) ArticleTitleEndoscopic oesophagectomy through a right thoracoscopic approach. J R Coll Surg Edinb 37 7–11 Occurrence Handle1:STN:280:By2B2czkt1U%3D Occurrence Handle1573620

    CAS  PubMed  Google Scholar 

  5. B Dallemagne JM Weerts C Jehaes S Markiewicz S Bona JL Hosselet O Vadhat R Lombard (1992) ArticleTitleCase report: subtotal oesophagectomy by thoracoscopy and laparoscopy. Minim Invas Ther 1 183–185

    Google Scholar 

  6. AL DePaula K Hashiba EA Ferreira RA Paula Particlede E Grecco (1995) ArticleTitleLaparoscopic transhiatal esophagectomy with esophagogastroplasty. Surg Laparosc Endosc 5 1–5 Occurrence Handle1:STN:280:ByqB2MzkvVA%3D Occurrence Handle7735533

    CAS  PubMed  Google Scholar 

  7. J Csepel Particlede R Nahouraii M Gagner (2001) ArticleTitleLaparoscopic gastric bypass as a reoperative bariatric surgery for failed open restrictive procedures. Surg Endosc 15 393–397 Occurrence Handle10.1007/s004640000347 Occurrence Handle1:STN:280:DC%2BD38%2Fht1yhsg%3D%3D Occurrence Handle11395822

    Article  CAS  PubMed  Google Scholar 

  8. SP Dexter IG Martin MJ McMahon (1996) ArticleTitleRadical thoracoscopic esophagectomy for cancer. Surg Endosc 10 147–151 Occurrence Handle10.1007/s004649910034 Occurrence Handle1:STN:280:ByiD1cnkt1c%3D Occurrence Handle8932617

    Article  CAS  PubMed  Google Scholar 

  9. CD Gerhart (1998) ArticleTitleHand-assisted laparoscopic transhiatal esophagectomy using the dexterity pneumo sleeve. JSLS 2 295–298 Occurrence Handle1:STN:280:DyaK1M%2FpsVSguw%3D%3D Occurrence Handle9876759

    CAS  PubMed  Google Scholar 

  10. RA Hinder CJ Filipi G Wetscher P Neary TR DeMeester G Perdikis (1994) ArticleTitleLaparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease. Ann Surg 220 472–481 Occurrence Handle1:STN:280:ByqD3s7jsVI%3D Occurrence Handle7944659

    CAS  PubMed  Google Scholar 

  11. P Jagot A Sauvanet L Berthoux J Belghiti (1996) ArticleTitleLaparoscopic mobilization of the stomach for oesophageal replacement. Br J Surg 83 540–542 Occurrence Handle1:STN:280:BymB28zhsFc%3D Occurrence Handle8665254

    CAS  PubMed  Google Scholar 

  12. K Kawahara T Maekawa K Okabayashi T Hideshima T Shiraishi Y Yoshinaga T Shirakusa (1999) ArticleTitleVideo-assisted thoracoscopic esophagectomy for esophageal cancer. Surg Endosc 13 218–223 Occurrence Handle10.1007/s004649900948 Occurrence Handle1:STN:280:DyaK1M7msFyqtA%3D%3D Occurrence Handle10064749

    Article  CAS  PubMed  Google Scholar 

  13. RM King PC Pairolero VF Trastek WS Payne PE Bernatz (1987) ArticleTitleIvor Lewis esophagogastrectomy for carcinoma of the esophagus: early and late functional results. Ann Thorac Surg 44 119–122 Occurrence Handle1:STN:280:BiiB1MjntVU%3D Occurrence Handle3619535

    CAS  PubMed  Google Scholar 

  14. S Law C Arcilla KM Chu J Wong (1998) ArticleTitleThe significance of histologically infiltrated resection margin after esophagectomy for esophageal cancer. Am J Surg 176 286–290 Occurrence Handle10.1016/S0002-9610(98)00140-8 Occurrence Handle1:STN:280:DyaK1cvkslSmtA%3D%3D Occurrence Handle9776161

    Article  CAS  PubMed  Google Scholar 

  15. I Lewis (1946) ArticleTitleThe surgical treatment of carcinoma of the esophagus with special reference to a new operation for growths of the middle third. Br J Surg 34 18–31

    Google Scholar 

  16. P Lozach P Topart J Etienne JF Charles (1991) ArticleTitleIvor Lewis operation for epidermoid carcinoma of the esophagus. Ann Thorac Surg 52 1154–1157 Occurrence Handle1:STN:280:By2D287ivFU%3D Occurrence Handle1953140

    CAS  PubMed  Google Scholar 

  17. JD Luketich NT Nguyen T Weigel P Ferson R Keenan P Schauer (1998) ArticleTitleMinimally invasive approach to esophagectomy. JSLS 2 243–247 Occurrence Handle1:STN:280:DyaK1M%2FpsVShtQ%3D%3D Occurrence Handle9876747

    CAS  PubMed  Google Scholar 

  18. JD Luketich PR Schauer NA Christie TL Weigel S Raja HC Fernando RJ Keenan NT Nguyen (2000) ArticleTitleMinimally invasive esophagectomy. Ann Thorac Surg 70 906–911 Occurrence Handle10.1016/S0003-4975(00)01711-2 Occurrence Handle1:STN:280:DC%2BD3cvmtlGjsA%3D%3D Occurrence Handle11016332

    Article  CAS  PubMed  Google Scholar 

  19. NT Nguyen DM Follette PH Lemoine PF Roberts JE Goodnight SuffixJr (2001) ArticleTitleMinimally invasive Ivor Lewis esophagectomy. Ann Thorac Surg 72 593–596 Occurrence Handle10.1016/S0003-4975(00)02261-X Occurrence Handle1:STN:280:DC%2BD3MvntFaqsg%3D%3D Occurrence Handle11515902

    Article  CAS  PubMed  Google Scholar 

  20. NT Nguyen DM Follette BM Wolfe PD Schneider P Roberts JE Goodnight SuffixJr (2000) ArticleTitleComparison of minimally invasive esophagectomy with transthoracic and transhiatal esophagectomy. Arch Surg 135 920–925 Occurrence Handle10.1001/archsurg.135.8.920 Occurrence Handle1:STN:280:DC%2BD3cvhs12rsg%3D%3D Occurrence Handle10922253

    Article  CAS  PubMed  Google Scholar 

  21. MB Orringer B Marshall MC Stirling (1993) ArticleTitleTranshiatal esophagectomy for benign and malignant disease. J Thorac Cardiovasc Surg 105 265–276 Occurrence Handle1:STN:280:ByyC2MnjtFE%3D Occurrence Handle8429654

    CAS  PubMed  Google Scholar 

  22. LL Swanstrom P Hansen (1997) ArticleTitleLaparoscopic total esophagectomy. Arch Surg 132 943–947 Occurrence Handle1:STN:280:ByiH2cjhsFA%3D Occurrence Handle9301605

    CAS  PubMed  Google Scholar 

  23. DI Watson N Davies GG Jamieson (1999) ArticleTitleTotally endoscopic Ivor Lewis esophagectomy. Surg Endosc 13 293–297 Occurrence Handle10.1007/s004649900969 Occurrence Handle1:STN:280:DyaK1M7msF2itQ%3D%3D Occurrence Handle10064770

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Clinique de Chirurgie Digestive, CHU Saint-Pierre, Université Libre de Bruxelles, 322, Rue Haute, 1000, Brussels, Belgium

    R. Costi, J. Himpens, J. Bruyns & G. B. Cadière

  2. Dipartimento di Scienze Chirurgiche, Università di Parma, Italia

    R. Costi

Authors
  1. R. Costi
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  2. J. Himpens
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  3. J. Bruyns
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  4. G. B. Cadière
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Correspondence to G. B. Cadière.

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Costi, R., Himpens, J., Bruyns, J. et al. Totally laparoscopic transhiatal esophago-gastrectomy without thoracic or cervical access: The least invasive surgery for adenocarcinoma of the cardia?. Surg Endosc 18, 629–632 (2004). https://doi.org/10.1007/s00464-003-9053-5

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