Laparoscopic transhiatal esophagectomy at a low-volume center.
| Autor: | Santin BJ; Mount Carmel Health System, Columbus, Ohio 43222, USA. briansantin@gmail.com, Price P |
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| Jazyk: | angličtina |
| Zdroj: | JSLS : Journal of the Society of Laparoendoscopic Surgeons [JSLS] 2011 Jan-Mar; Vol. 15 (1), pp. 41-6. |
| DOI: | 10.4293/108680811X13022985131138 |
| Abstrakt: | Background and Objectives: Surgical treatment of esophageal cancer is associated with a high rate of morbidity, even in specialized centers. Minimally invasive esophageal resection has become increasingly feasible and is gaining popularity in some high-volume institutions. This study assesses the short-term outcomes of laparoscopic transhiatal esophagectomy performed by a single surgeon at a single low-volume institution over a 20-month period. Methods: Over the study period, 16 patients underwent laparoscopic transhiatal esophagectomy. All patients were men with an average age of 70 years (range, 50 to 81). Results: Two patients required intraoperative conversion to alternative surgical techniques, 1 to an Ivor-Lewis esophagectomy and 1 to an open transhiatal approach. Average operative time was 198 minutes (range, 147 to 303). Mean hospital stay was 16.7 days (range, 9 to 30). The average number of resected lymph nodes was 11.7, and 2 patients had benign pathology. No deaths occurred in the 30-day postoperative period. Conclusion: Laparoscopic transhiatal esophagectomy is an advanced laparoscopic procedure that can be performed with equivalent morbidity and mortality by a low-volume surgeon in a low-volume center with results comparable to those of high-volume centers. While several authors have demonstrated a correlation between lower mortality rates and high-volume esophagectomy hospitals, our results support surgeon experience as more important than the absolute number of procedures performed each year. |
| Databáze: | MEDLINE |
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