| A preliminary experience with minimally invasive Ivor Lewis esophagectomy. | |
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MedLine Citation:
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PMID: 21967644 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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With several small series examining minimally invasive Ivor Lewis esophagectomies, we look to contribute to a growing experience. In reporting our initial results, safety, initial oncologic completeness, and preliminary outcomes with a minimally invasive Ivor Lewis esophagectomy were demonstrated. From 2007 to 2010, 40 minimally invasive Ivor Lewis esophagectomies were carried out. The approach was a laparoscopic mobilization of the stomach and a thoracoscopic esophageal mobilization and creation of a high intrathoracic anastomosis. Indications included esophageal cancer in 39 patients and esophageal gastrointestinal stromal tumor in one patient. Median age was 62 (range 39-77) with 31 (78%) male patients. Non-emergent conversion was required in two (5%) patients. Twenty-five (63%) patients underwent neoadjuvant therapy. Mean operative time was 364 minutes (range 285-455), and mean blood loss was 205 cc (range 100-400). All patients underwent an R0 resection including the removal of all Barrett's esophagus, and mean number of nodes harvested was 21 (range 11-41). Median intensive care unit stay was 1 day (range 1-3), and hospital stay was 7 days (range 6-19). There were no anastomotic leaks and no 30-day mortality. Postoperative complications included eight (21%) patients with atrial fibrillation and two (5%) chylothorax, one requiring ligation. At a mean follow-up of 16.5 months (range 1-39 months), five (13%) patients have had a distant recurrence; there have been no local recurrences. Minimally invasive Ivor Lewis esophagectomy, although technically challenging, can be carried out with reasonable operative times, a short length of stay, and minimal complication. Final oncologic validity is pending longer follow-up and a larger series. |
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Authors:
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L F Tapias; C R Morse |
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Publication Detail:
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Type: Journal Article Date: 2011-10-03 |
Journal Detail:
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Title: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus / I.S.D.E Volume: 25 ISSN: 1442-2050 ISO Abbreviation: Dis. Esophagus Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-07-04 Completed Date: 2012-12-05 Revised Date: 2013-02-06 |
Medline Journal Info:
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Nlm Unique ID: 8809160 Medline TA: Dis Esophagus Country: Australia |
Other Details:
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Languages: eng Pagination: 449-55 Citation Subset: IM |
Copyright Information:
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© 2011 Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus. |
Affiliation:
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Division of Thoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma
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surgery* Adult Aged Barrett Esophagus / surgery Blood Loss, Surgical / statistics & numerical data Carcinoma, Squamous Cell / surgery* Esophageal Neoplasms / surgery* Esophagectomy / methods* Female Humans Laparoscopy / methods Length of Stay / statistics & numerical data Male Middle Aged Postoperative Complications / epidemiology* Surgical Procedures, Minimally Invasive / methods Thoracic Surgery, Video-Assisted / methods* Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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