Minimally Invasive Transhiatal Esophagectomy Using Antegrade Inversion Technique in Esophageal Cancer: 10-Year Experience from a Tertiary Care Center.

IF 1.1 4区 医学 Q3 SURGERY
Thitiporn Chobarporn, Alia Qureshi, John G Hunter, Stephanie G Wood
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引用次数: 0

Abstract

Background: Esophageal cancer surgery aims for curative intent but carries high complication rates. Transthoracic esophagectomy is the dominant approach, however, transhiatal esophagectomy (THE) offers selective advantages in certain clinical scenarios. Minimally invasive THE (MI-THE) is an evolving technique with limited data. Methods: This retrospective study reviewed 38 patients with esophageal cancer who underwent MI-THE using "Antegrade Inversion Technique" between 2013 and 2023 at a tertiary care center. Perioperative outcomes were analyzed. Data were presented as mean with standard deviation, median with interquartile range, and percentages. Results: Most patients (86.8%) had early-stage cancer. Median operative time was 375 minutes, hospital stay was 8 days, and intensive care unit stay was 3 days. All patients achieved a negative resection margin. Pleural effusion (57.9%) was the most common complication, followed by pneumothorax (31.6%) and surgical site infection (15.8%). Anastomotic leak rate was 13.2%. There was no mortality. Conclusions: MI-THE appears safe and feasible with encouraging perioperative outcomes, particularly for early-stage disease and high-risk patients. While potentially offering advantages over open THE, further research is needed to definitively establish its role compared to traditional approaches.

使用前向倒转技术的微创经食管癌食管切除术:一家三级医疗中心的十年经验。
背景:食管癌手术以治愈为目的,但并发症发生率很高。经胸食管切除术是最主要的方法,但经食管裂孔食管切除术(THE)在某些临床情况下具有选择性优势。微创食管切除术(MI-THE)是一种不断发展的技术,但数据有限。方法:这项回顾性研究回顾了一家三级医疗中心在 2013 年至 2023 年期间使用 "前向反转技术 "进行 MI-THE 手术的 38 例食管癌患者。对围手术期的结果进行了分析。数据以平均值(含标准差)、中位数(含四分位距)和百分比表示。结果大多数患者(86.8%)为早期癌症。手术时间中位数为 375 分钟,住院时间为 8 天,重症监护室住院时间为 3 天。所有患者的切除边缘均为阴性。胸腔积液(57.9%)是最常见的并发症,其次是气胸(31.6%)和手术部位感染(15.8%)。吻合口漏率为13.2%。无死亡病例。结论MI-THE似乎安全可行,围手术期效果令人鼓舞,尤其是对于早期疾病和高风险患者。与开放式THE相比,MI-THE具有潜在的优势,但要明确其与传统方法相比的作用,还需要进一步的研究。
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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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