A laparoscopy-assisted surgical approach to esophageal carcinoma
| Autor: | Luigi Bonavina, Davide Bona, Alberto Peracchia, Pierre René Binyom |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty Esophageal Neoplasms medicine.medical_treatment Adenocarcinoma Barrett Esophagus Laparotomy Carcinoma medicine Humans Thoracotomy Esophagus Laparoscopy Aged Neoplasm Staging Aged 80 and over medicine.diagnostic_test Esophageal disease business.industry General surgery Middle Aged medicine.disease Endoscopy Surgery Esophagectomy medicine.anatomical_structure Treatment Outcome Carcinoma Squamous Cell Female business |
| Zdroj: | The Journal of surgical research. 117(1) |
| ISSN: | 0022-4804 |
| Popis: | Background. Surgical resection is the treatment of choice for esophageal carcinoma. Over the past decade, laparoscopy has proven an accurate staging modality for detecting peritoneal carcinosis and small metastatic liver deposits unsuspected at preoperative investigation. This has led to a change in surgical strategy in up to 20% of patients. In addition, by means of laparoscopic techniques, it is possible to mobilize the stomach and perform a safe transhiatal mediastinal dissection at least up to the level of the inferior pulmonary veins. Patients and methods. Laparoscopy-assisted esophagectomy was attempted in 43 patients over the past 3 years. The esophagectomy was performed via laparoscopy combined with right thoracotomy (group A) or with left cervicotomy and transmediastinal endodissection (group B). Results. The overall conversion rate to laparotomy was 11.6%. No hospital deaths occurred. The morbidity rate was 20% in group A and 30.7% in group B. The mean hospital stay was 11 in group A and 10 days in group B. Five patients died between 11 and 19 months after surgery with recurrent disease. No port-site metastases were recorded during follow-up. Conclusions. This approach has proven feasible and safe in the medium-term follow-up. Further experience and a longer follow-up are needed to assess the impact of these procedures on long-term survival. |
| Databáze: | OpenAIRE |
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