Transcervical Endoscopic Esophageal Mobilization: An Approach to Transhiatal Esophagectomy

Annals of thoracic surgery short reports Pub Date : 2025-03-01 DOI:10.1016/j.atssr.2024.09.011

Jennifer Livschitz MD, MS , Joshua Melamed MD , Britton Donato MD , Amy Yoonjin Lee MD , Huaying Dong BS , Aniko Szabo PhD , William B. Tisol MD , Paul L. Linsky MD , Mario G. Gasparri MD , David W. Johnstone MD

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引用次数: 0

Abstract

Background

Transcervical endoscopic esophageal mobilization (TEEM) is an approach to transhiatal esophagectomy that aims to minimize blood loss and decrease the operative time commonly associated with traditional transhiatal technique.

Methods

A retrospective chart review was conducted on patients who underwent TEEM esophagectomy between 2009 and 2020. Baseline characteristics, perioperative outcomes, and postoperative complications were recorded. To report survival, a Kaplan-Meier survival plot was developed using SAS software (SAS Institute).

Results

A total of 241 patients underwent TEEM esophagectomy. The mean operative time was 185.1 ± 59.3 minutes, blood loss was 251.4 ± 212.3 mL, the number lymph nodes dissected was 13.6 ± 6.2, and the length of stay was 11.9 ± 8.5 days. In the postoperative setting, 68 (28.2%) patients experienced hoarseness, 62 (25.7%) had postoperative atrial fibrillation, 30 (12.4%) had an anastomotic leak, and 12 (4.6%) experienced chylothorax. The overall 30- and 90-day mortality rates were 2.1% (5 of 241) and 4.6% (11 of 241), respectively. The median overall survival was 2.36 years, with 60% 3-year survival and 40% 5-year survival.

Conclusions

TEEM esophagectomy is a safe approach with acceptable postoperative morbidity and mortality and shorter operative times compared with historical norms.

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经颈内镜食管动员：经食管切除术的一种方法

背景经颈内镜食管动员术（TEEM）是一种经食管切除术的方法，其目的是减少出血量，缩短传统的经食管切除术的手术时间。方法回顾性分析2009 ~ 2020年行TEEM食管切除术患者的资料。记录基线特征、围手术期结果和术后并发症。为了报告生存情况，使用SAS软件（SAS Institute）绘制Kaplan-Meier生存图。结果共241例患者行TEEM食管切除术。平均手术时间185.1±59.3 min，出血量251.4±212.3 mL，清扫淋巴结数13.6±6.2个，住院时间11.9±8.5 d。术后68例（28.2%）患者出现声音嘶哑，62例（25.7%）患者出现房颤，30例（12.4%）患者出现吻合口漏，12例（4.6%）患者出现乳糜胸。30天和90天的总死亡率分别为2.1%（241人中的5人）和4.6%（241人中的11人）。中位总生存率为2.36年，其中3年生存率为60%，5年生存率为40%。结论steem食管切除术是一种安全的手术方式，术后发病率和死亡率可接受，手术时间较历史标准短。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of thoracic surgery short reports Surgery

自引率

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审稿时长

53 days