Document Detail


Initial results of minimally invasive ivor lewis esophagectomy after induction chemoradiation (50.4 gy) for esophageal cancer.
MedLine Citation:
PMID:  23422805     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: Esophageal cancer patients receiving induction chemoradiation to 41 Gy randomized to minimally invasive (MIS) esophagectomy have fewer postoperative pulmonary complications compared with those who underwent open procedures. We evaluated the feasibility of MIS Ivor Lewis esophagectomy in patients treated with induction chemoradiation to 50.4 Gy.
METHODS: We retrospectively analyzed clinical data from 30 consecutive patients undergoing MIS Ivor Lewis esophagectomy after induction chemoradiation to a mean dose of 50.4 Gy by a single surgeon at a tertiary institution since 2010. Data collected included patient demographics, preoperative risk factors, neoadjuvant treatment modalities, histology, staging, operative factors, and perioperative complications.
RESULTS: The mean age of the patients was 61 ± 9.5 years, and 87% were men. The dominant histology was adenocarcinoma (90%), with most tumors (70%) located at the gastroesophageal junction. A total of 22 patients (73%) presented with dysphagia, but only 15 (50%) had associated weight loss (mean 12.2% total body mass). All patients had R0 resections; mean number of resected lymph nodes was 27.1 ± 11.4. Mean operating room time was 535 ± 120 minutes, with the last 10 operations 2 hours shorter than the preceding 20. Four patients (13.3%) had major complications. including 2 (6.7%) anastomotic leaks. There was no operative mortality.
CONCLUSIONS: Minimally invasive Ivor Lewis esophagectomy after chemoradiation to 50.4 Gy can be performed with decreased morbidity and mortality compared with historical series of open Ivor Lewis esophagectomy. Oncologic outcomes were acceptable as demonstrated by lymph node retrieval and complete resection rates. Operative time decreased significantly after 20 cases.
Authors:
Alan A Thomay; Justin A Snyder; Donna M Edmondson; Walter J Scott
Related Documents :
24319335 - Aqueous cytokines as predictors of macular edema in non-diabetic patients following unc...
23981815 - Sexual quality of life after hormonal and surgical treatment, including phalloplasty, i...
24882135 - Scheduling of procedures and staff in an ambulatory surgery center.
25142755 - Redo valve surgery-current status and future perspectives.
22110835 - Transoral surgery for morbid obesity.
12797685 - Congenital blepharoptosis: part ii. visual disorders coexisting with congenital blephar...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Innovations (Philadelphia, Pa.)     Volume:  7     ISSN:  1559-0879     ISO Abbreviation:  Innovations (Phila)     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2013-02-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101257528     Medline TA:  Innovations (Phila)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  421-8     Citation Subset:  IM    
Affiliation:
From the *Department of Surgical Oncology and †Division of Thoracic Surgery, Fox Chase Cancer Center, Philadelphia, PA USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Left atrial roof: an alternative minimal approach for mitral valve surgery.
Next Document:  Double potential mapping: a novel technique for locating the site of incomplete ablation.