Document Detail


A preliminary experience with minimally invasive Ivor Lewis esophagectomy.
MedLine Citation:
PMID:  21967644     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
L F Tapias; C R Morse
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Publication Detail:
Type:  Journal Article     Date:  2011-10-03
Journal Detail:
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:
Created Date:  2012-07-04     Completed Date:  2012-12-05     Revised Date:  2013-02-06    
Medline Journal Info:
Nlm Unique ID:  8809160     Medline TA:  Dis Esophagus     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  449-55     Citation Subset:  IM    
Copyright Information:
© 2011 Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.
Affiliation:
Division of Thoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / 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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