Single-incision laparo-thoracoscopic minimally invasive oesophagectomy to treat oesophageal cancer
Journal
European Journal of Cardio-thoracic Surgery
Journal Volume
49
Pages
i59-i63
ISBN
26547093
Date Issued
2015
Author(s)
Abstract
OBJECTIVES: Single-incision thoracoscopic and laparoscopic procedures have been applied in treating various diseases. However, it is unknown whether such procedures are feasible in treating oesophageal cancer. METHODS: Minimally invasive oesophagectomy (MIO) with a single-incision approach in the thoracoscopic and laparoscopic procedures was attempted in 16 patients with oesophageal cancer. RESULTS: One patient was converted to laparotomy and a four-port thoracoscopic procedure due to bleeding. Of the patients successfully treated with a single-port MIO, 6 underwent a McKeown procedure and 9 an Ivor Lewis procedure, including 3 cases of total laryngopharyngo- oesophagectomy with cervical pharyngogastrostomy. The mean ventilator usage of the patients after surgery was 0.3 ± 0.6 days, the mean intensive care unit (ICU) stay was 3.8 ± 3.1 days and the mean number of dissected lymph nodes was 28.6 ± 14.6. One delayed anastomotic leakage occurred, and another patient developed a trachea-oesophageal fistula induced by surgical clip-related tissue erosion, both of which were successfully treated by the placement of an oesophageal stent. No pulmonary complications or surgical mortalities occurred in the study. Minor complications developed in 2 patients, 1 experiencing pneumothorax and 1 postoperative delirium. When compared with traditional MIO in our series (n = 315), no statistical difference was found among patients receiving single-port MIO in terms of ventilator usage, ICU stay and the number of dissected lymph nodes. CONCLUSIONS: Single-port MIO seems to be a feasible option for treating patients with oesophageal cancer, which requires further evaluation and follow-up in the future. ? The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
SDGs
Other Subjects
adult; anastomosis leakage; Article; cancer staging; cancer surgery; clinical article; esophagus cancer; esophagus resection; female; human; lymph node dissection; male; minimally invasive surgery; operation duration; pneumothorax; postoperative delirium; priority journal; tracheoesophageal fistula; ventilator; adenocarcinoma; aged; Carcinoma, Squamous Cell; clinical trial; comparative study; Esophageal Neoplasms; esophagus resection; feasibility study; laparoscopy; middle aged; postoperative complication; procedures; thoracoscopy; treatment outcome; Adenocarcinoma; Adult; Aged; Carcinoma, Squamous Cell; Esophageal Neoplasms; Esophagectomy; Feasibility Studies; Female; Humans; Laparoscopy; Male; Middle Aged; Postoperative Complications; Thoracoscopy; Treatment Outcome
Publisher
European Association for Cardio-Thoracic Surgery
Type
journal article