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Complete minimally invasive Ivor-Lewis esophageal resection


Authors: P. Zonča;  M. Peteja;  V. Richter;  P. Vávra;  P. Ostruszka;  D. Worek;  J. Stigler
Authors‘ workplace: Chirurgická klinika, FN LF Ostravské univerzity přednosta: doc. MUDr. P. Zonča, Ph. D., FRCS, MBA
Published in: Rozhl. Chir., 2017, roč. 96, č. 3, s. 114-119.
Category: Original articles

Overview

Introduction:
Minimally invasive esophagectomy is becoming a standard procedure in the treatment of esophageal cancer. We would like to present our experience with Ivor Lewis esophagectomy completed by minimally invasive technique.

Methods:
The primary aim of the study was to analyse potential technical difficulties and intraoperative complications of thoracolaparoscopic Ivor Lewis esophagectomy with intrathoracic anastomosis. A secondary aim of the study was to evaluate postoperative complications according to the Clavien-Dindo classification. The inclusion criterion for the study was a history of thoracolaparoscopic esophagectomy. Multidisciplinary approach was employed in the diagnosis, surgery indications and perioperative care of all patients.

Results:
Between January 2011 and January 2016, 19 patients underwent completely minimally invasive esophagectomy with intrathoracic anastomosis. There were 13 men and 6 women. Adenocarcinoma was confirmed by histopathological examination in all the patients. The cumulative postoperative morbidity was 68.4%. According to the Clavien-Dindo classification, we recorded grade I complications in 10.5% of the patients, grade II in 15.8%, grade III in 36.8% and grade IV in 5.3% of the patients. Anastomotic leak was the most serious complication; it was initially managed by negative pressure (vacuum) therapy followed by stent implantation. Postoperative mortality was 0%. Mean hospital stay was 12 days and mean stay at intensive care unit was 3.6 days.

Conclusions:
The basic oncosurgical principles of radicality need to be respected during minimally invasive procedures. However, functionality, safety, and cost effectiveness have to be preserved as well. In this paper, we present thoracolaparoscopic Ivor Lewis esophagectomy as one of feasible and accessible options of intrathoracic anastomosis. It seems to be safe with respect to technical obstacles, short-term and long-term complications.

Key words:
esophagectomy – intrathoracic – anastomosis – laparoscopy – thoracoscopy


Sources

1. Dantoc MM, Cox MR, Eslick GD. Does minimally invasive esophagectomy (MIE) provide for comparable oncologic outcomes to open techniques? A systematic review. J Gastrointest Surg. 2012;16:486–94.

2. Biere SS, Cuesta MA, van der Peet DL. Minimally invasive versus open esophagectomy for cancer: a systematic review and meta-analysis. Minerva Chir. 2009;64:121–33.

3. Biere SS, van Berge Henegouwen MI, Maas KW, et al. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet 2012;379:1887–92.

4. National Comprehensive Cancer Network, Inc., Esophageal and Esophagogastric Junction Cancer 2.2016, accessed December 1st, 2016.

5. Jagot P, Sauvanet A, Berthoux L, et al. Laparoscopic mobilization of the stomach for oesophageal replacement. Br J Surg 1996;83:540–2.

6. Ben-David K, Sarosi GA, Cendan JC, et al. Technique of minimally invasive Ivor Lewis esophagogastrectomy with intrathoracic stapled side-to-side anastomosis. J Gastrointest Surg 2010;14:1613–8.

7. Nguyen NT, Follette DM, Lemoine PH, et al. Minimally invasive Ivor Lewis esophagectomy. Ann Thorac Surg 2001; 72:593– 6.

8. Luketich JD, Alvelo-Rivera M, Buenaventura PO, et al. Minimally invasive esophagectomy: outcomes in 222 patients. Ann Thorac Surg 2003;238:486 –95.

9. Nguyen NT, Roberts P, Follette DM, et al. Thoracoscopic and laparoscopic esophagectomy for benign and malignant disease: lessons learned from 46 consecutive procedures. J Am Coll Surg 2003;197:902–13.

10. Jarral OA, Purkayastha S, Athanasiou T, et al. Thoracoscopic esophagectomy in the prone position. Surg Endosc. 2012;26:2095–103.

11. Siewert JR, Bartels H, Stein HJ. Abdomino-rechts-thorakale Ösophagusresektion mit intrathorakaler Anastomose bei Barrett-Karzinom. Chirurg 2005;76:588–94

12. Watson DI, Davies N, Jamieson GG. Totally endoscopic Ivor Lewis esophagectomy. Surg Endosc 1999;13:293−97.

13. Giugliano DN, Berger AC, Rosato EL, et al. Total minimally invasive esophagectomy for esophageal cancer: approaches and outcomes. Langenbecks Arch Surg. 2016;401:747−56.

14. Straatman J, van der Wielen N, Nieuwenhuijzen GA, et al. Techniques and short-term outcomes for total minimally invasive Ivor Lewis esophageal resection in distal esophageal and gastroesophageal junction cancers: pooled data from six European centers. Surg Endosc. 2017;31:119−26.

15. Zhai C, Liu Y, Li W, et al. A comparison of short-term outcomes between Ivor-Lewis and McKeown minimally invasive esophagectomy. J Thorac Dis 2015;7:2352−8.

16. See comment in PubMed Commons below Findlay L, Yao C, Bennett DH, et al. Non-inferiority of minimally invasive oesophagectomy: an 8-year retrospective case series. Surg Endosc 2017; [Epub ahead of print]

17. Luketich JD, Alvelo-Rivera M, Buenaventura PO, et al. Minimally invasive esophagectomy: outcomes in 222 patients. Ann Surg 2003;238:486–94.

18. Weidenhagen R, Hartl WH, Gruetzner KU, et al. Anastomotic leakage after esophageal resection: new treatment options by endoluminal vacuum therapy. Ann Thorac Surg 2013;90:1674–81.

19. Lee KW, Leung KF, Wong KK, et al. One-stage thoracoscopic oesophagectomy: ligature intrathoracic stapled anastomosis. Aust N Z J Surg 1997;67:131–2.

20. Nguyen NT, Follette DM, Lemoine PH, et al. Minimally invasive Ivor Lewis esophagectomy. Ann Thorac Surg 2001;72:593–6.

21. Luketich JD, Pennathur A, Awais O, et al. Outcomes after minimally invasive esophagectomy: review of over 1000 patients. Ann Surg 2012;256:95–103.

22. Zonca P, Stigler J, Maly T, et al. Do we really apply fast-track surgery? Bratisl Lek Listy 2008;109:61−5.

23. Vomackova K, Neoral C, Aujesky R, et al. The benefit of PET/CT in the diagnosis and treatment of esophageal cancer. Rozhl Chir 2015;94:8−16.

24. Aujeský R, Neoral Č. [Modern approach to esophageal carcinoma.] Czech, Rozhl Chir. 2012;91:568-73.

25. Pazdro A, Harustiak T, Snajdauf M, et al. [Esophageal perforation.] Czech Rozhl Chir 2011;90:647−52.

26. Aujesky R, Neoral C, Kral V, et al. [Video-assisted esophageal resection for carcinoma – ten-year experience.] Czech, Rozhl Chir 2010;89:746−9.

27. Runkel N, Walz M, Ketelhut M. Abdominothorakale Ösophagusresektion nach Ivor-Lewis mit intrathorakaler Anastomose, Standardisierte total-minimalinvasive Technik Chirurg 2015;86:468–75.

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Surgery Orthopaedics Trauma surgery
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