Technique of Minimally Invasive Ivor Lewis Esophagogastrectomy with Intrathoracic Stapled Side-to-side Anastomosis

Overview

Journal J Gastrointest Surg

Specialty Gastroenterology

Date 2010 Jun 10

PMID 20532663

Citations 21

Authors

Kfir Ben-David

George A Sarosi

Juan C Cendan

Steven N Hochwald

Affiliations

Soon will be listed here.

Abstract

Objective: An intrathoracic linear stapled side-to-side anastomosis for gastroesophageal junction malignancy is feasible, results in low leak rates and less stenosis.

Design: Retrospective case series.

Setting: University tertiary care center.

Patients: Between March 2008 and January 2009, six patients with gastroesophageal junction malignancy undergoing minimally invasive esophagectomy with an intrathoracic linear stapled side-to-side anastomosis were identified and their clinicopathological data analyzed.

Main Outcome Measures: Technique of a 6-cm side-to-side stapled intrathoracic esophagogastric anastomosis.

Results: Six patients underwent a minimally invasive esophagectomy with a side-to-side stapled intrathoracic esophagogastric anastomosis. Median age was 61.5 years. All patients had gastroesophageal junction adenocarcinoma and completed neoadjuvant chemoradiation therapy. The median operative time was 360 min. No patient received a blood transfusion. The 30-day mortality was 0. The median length of hospital stay was 8 days. The median number of nodes harvested was 18. At a median follow-up of 9 months, all patients were alive. There have been no anastomotic strictures to date.

Conclusion: A 6-cm side-to-side stapled intrathoracic esophagogastric anastomosis is feasible and is associated with a low anastomotic leak rate.

Citing Articles

Surgical Technique and Implementation of Total Minimally Invasive (Laparo-Thoracoscopic) Ivor Lewis Esophagectomy for Cancer.

Puccetti F, Battaglia S, Carresi A, Cinelli L, Turi S, Elmore U Cancers (Basel). 2024; 16(19).

PMID: 39409904 PMC: 11475372. DOI: 10.3390/cancers16193281.

Acute gastric conduit dilation after minimally invasive esophagectomy: a 10-year experience.

Takahashi H, Peng J, Brady M, Roche C, Catalfamo K, Attwood K Dis Esophagus. 2022; 35(12).

PMID: 35649395 PMC: 9752943. DOI: 10.1093/dote/doac033.

Comparison of Two Circular-Stapled Techniques for Esophageal Cancer: A Propensity-Matched Analysis.

Lin H, Liang G, Chai H, Liao Y, Zhang C, Cheng Y Front Oncol. 2022; 11:759599.

PMID: 34976807 PMC: 8716395. DOI: 10.3389/fonc.2021.759599.

Learning curve for minimally invasive oesophagectomy of oesophageal cancer and survival analysis.

Zhao Y, Shan L, Peng C, Cong B, Zhao X J Cardiothorac Surg. 2021; 16(1):328.

PMID: 34758861 PMC: 8579515. DOI: 10.1186/s13019-021-01712-7.

Side-to-side esophagogastric anastomosis for minimally invasive Ivor-Lewis esophagectomy: operative technique and short-term outcomes.

Fabbi M, De Pascale S, Ascari F, Petz W, Romario U Updates Surg. 2021; 73(5):1837-1847.

PMID: 33900550 PMC: 8500894. DOI: 10.1007/s13304-021-01054-y.

References

Gerhart C . Hand-assisted laparoscopic transhiatal esophagectomy using the dexterity pneumo sleeve. JSLS. 1999; 2(3):295-8. PMC: 3015310. View

Verhage R, Hazebroek E, Boone J, van Hillegersberg R . Minimally invasive surgery compared to open procedures in esophagectomy for cancer: a systematic review of the literature. Minerva Chir. 2009; 64(2):135-46. View

Horgan S, Berger R, Elli E, Espat N . Robotic-assisted minimally invasive transhiatal esophagectomy. Am Surg. 2003; 69(7):624-6. View

McLarty A, Deschamps C, Trastek V, Allen M, Pairolero P, Harmsen W . Esophageal resection for cancer of the esophagus: long-term function and quality of life. Ann Thorac Surg. 1997; 63(6):1568-72. DOI: 10.1016/s0003-4975(97)00125-2. View

Santos R, Raftopoulos Y, Singh D, DeHoyos A, Fernando H, Keenan R . Utility of total mechanical stapled cervical esophagogastric anastomosis after esophagectomy: a comparison to conventional anastomotic techniques. Surgery. 2004; 136(4):917-25. DOI: 10.1016/j.surg.2004.06.032. View

Braghetto I, Csendes A, Cardemil G, Burdiles P, Korn O, VALLADARES H . Open transthoracic or transhiatal esophagectomy versus minimally invasive esophagectomy in terms of morbidity, mortality and survival. Surg Endosc. 2006; 20(11):1681-6. DOI: 10.1007/s00464-006-0009-4. View

Bernabe K, Bolton J, Richardson W . Laparoscopic hand-assisted versus open transhiatal esophagectomy: a case-control study. Surg Endosc. 2005; 19(3):334-7. DOI: 10.1007/s00464-004-8807-z. View

Behzadi A, Nichols F, Cassivi S, Deschamps C, Allen M, Pairolero P . Esophagogastrectomy: the influence of stapled versus hand-sewn anastomosis on outcome. J Gastrointest Surg. 2005; 9(8):1031-40. DOI: 10.1016/j.gassur.2005.06.025. View

Headrick J, Nichols 3rd F, Miller D, Allen M, Trastek V, Deschamps C . High-grade esophageal dysplasia: long-term survival and quality of life after esophagectomy. Ann Thorac Surg. 2002; 73(6):1697-702; discussion 1702-3. DOI: 10.1016/s0003-4975(02)03496-3. View

10.

Benzoni E, Bresadola V, Terrosu G, Uzzau A, Cedolini C, Intini S . Minimally invasive esophagectomy: a comparative study of transhiatal laparoscopic approach versus laparoscopic right transthoracic esophagectomy. Surg Laparosc Endosc Percutan Tech. 2008; 18(2):178-87. DOI: 10.1097/SLE.0b013e318165f205. View

11.

Luketich J, Alvelo-Rivera M, Buenaventura P, Christie N, McCaughan J, Litle V . Minimally invasive esophagectomy: outcomes in 222 patients. Ann Surg. 2003; 238(4):486-94. PMC: 1360107. DOI: 10.1097/01.sla.0000089858.40725.68. View

12.

Dapri G, Himpens J, Cadiere G . Robot-assisted thoracoscopic esophagectomy with the patient in the prone position. J Laparoendosc Adv Surg Tech A. 2006; 16(3):278-85. DOI: 10.1089/lap.2006.16.278. View

13.

Cassivi S . Leaks, strictures, and necrosis: a review of anastomotic complications following esophagectomy. Semin Thorac Cardiovasc Surg. 2004; 16(2):124-32. DOI: 10.1053/j.semtcvs.2004.03.011. View

14.

Zhou J, Chen H, Lu J, Xiang J, Zhang Y, Hu H . Application of a modified McKeown procedure (thoracoscopic esophageal mobilization three-incision esophagectomy) in esophageal cancer surgery: initial experience with 30 cases. Dis Esophagus. 2009; 22(8):687-93. DOI: 10.1111/j.1442-2050.2009.00963.x. View

15.

Fabian T, McKelvey A, Kent M, Federico J . Prone thoracoscopic esophageal mobilization for minimally invasive esophagectomy. Surg Endosc. 2007; 21(9):1667-70. DOI: 10.1007/s00464-007-9193-0. View

16.

Sanders G, Borie F, Husson E, Blanc P, Di Mauro G, Claus C . Minimally invasive transhiatal esophagectomy: lessons learned. Surg Endosc. 2007; 21(7):1190-3. DOI: 10.1007/s00464-007-9312-y. View

17.

Nguyen N, Hinojosa M, Smith B, Chang K, Gray J, Hoyt D . Minimally invasive esophagectomy: lessons learned from 104 operations. Ann Surg. 2008; 248(6):1081-91. DOI: 10.1097/SLA.0b013e31818b72b5. View

18.

Luketich J, Nguyen N, Weigel T, Ferson P, Keenan R, Schauer P . Minimally invasive approach to esophagectomy. JSLS. 1999; 2(3):243-7. PMC: 3015302. View

19.

DePaula A, Hashiba K, Ferreira E, de Paula R, Grecco E . Laparoscopic transhiatal esophagectomy with esophagogastroplasty. Surg Laparosc Endosc. 1995; 5(1):1-5. View

20.

Bizekis C, Kent M, Luketich J, Buenaventura P, Landreneau R, Schuchert M . Initial experience with minimally invasive Ivor Lewis esophagectomy. Ann Thorac Surg. 2006; 82(2):402-6. DOI: 10.1016/j.athoracsur.2006.02.052. View