Thoracoscopic mobilization of the esophagus - A 6 year experience

Smithers, B. M., Gotley, D. C., McEwan, D., Martin, I., Bessell, J. and Doyle, L. (2001) Thoracoscopic mobilization of the esophagus - A 6 year experience. Surgical Endoscopy, 15 2: 176-182. doi:10.1007/s004640000307


Author Smithers, B. M.
Gotley, D. C.
McEwan, D.
Martin, I.
Bessell, J.
Doyle, L.
Title Thoracoscopic mobilization of the esophagus - A 6 year experience
Journal name Surgical Endoscopy   Check publisher's open access policy
ISSN 0930-2794
Publication date 2001-02-01
Year available 2001
Sub-type Article (original research)
DOI 10.1007/s004640000307
Open Access Status
Volume 15
Issue 2
Start page 176
End page 182
Total pages 7
Place of publication New York
Publisher Springer-verlag
Language eng
Subject 110323 Surgery
Abstract Background: Traditionally, esophageal resection has been performed using a thoracotomy to access the intrathoracic esophagus. With the aim to avoid the potential morbidity of the open thoracic approach, mobilization of the esophagus under direct vision recently has been described. We report our experience at attempting thoracoscopic mobilization of the esophagus in 162 patients during a 6-year period. Methods: Patients with malignancy or end-stage benign disease of the esophagus considered suitable for a three-stage esophagectomy underwent a thoracoscopy with a view to endoscopic mobilization of the esophagus. Of the 162 patients in whom the procedure was attempted, it was abandoned in 9 patients (6%), and the procedure was converted to open surgery in 11 patients (7%). Results: In the patients whose esophagus was mobilized, the average blood loss was 165 ml, and the average time for the thoracoscopic segment of the surgery was 104 min. In the 133 patients who underwent a resection for invasive malignancy, a limited mediastinal nodal dissection retrieved an average of 11 nodes, and the median survival was 29 months. The 30-day mortality was 3.3% and the in-hospital mortality 5.3%. Conclusions: Thoracoscopic mobilization can be performed safely with satisfactory outcomes in a center performing a large volume of esophageal surgery and possessing advanced endoscopic surgery skills. Further assessment of this technique and comparisons with traditional open procedures are needed to assess this approach further as an appropriate oncologic procedure.
Keyword Surgery
esophageal carcinoma
esophagectomy
thoracoscopic mobilization
Esophagectomy
Cancer
Anastomosis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Sat, 26 Jan 2008, 01:21:33 EST