Experiences of thoracic esophagectomy with laparoscopic gastric pull up in thoracic esophageal cancer patient in single center

Abstract

Metastasis of esophageal cancer to adjacent organs commonly occurs due to the esophagus’ anatomical characteristic, wherein the serosa is absent, thereby making the surgical treatment difficult at the time of discovery. Nevertheless, when operable esophageal cancer is diagnosed, the gold standard for treatment is the Ivor-Lewis operation, which consists of esophagectomy, esophageal reconstruction, and anastomosis. The ideal conduit used for esophageal reconstruction should be an organ, requiring a relatively simple surgical technique, with similar size and function of the original esophagus, and with minimal complications after surgery [1]. The stomach has advantages over other organs like the colon and jejunum, such as appropriate length, lesser deviation in blood flow supply, easy to operate, and only requires a single anastomosis [2,3]. Since the introduction of minimally invasive esophagectomy in the 1990s, video-assisted thoracic surgery has been widely used [4], though our center currently uses open esophagectomy and laparoscopic gastric pull up (LGPU). Laparoscopic surgery is widely used owing to its variety of benefits, such as reduced hospital stay, reduced postoperative pain, and better cosmetic aspect, since laparoscopic cholecystectomy surgery was introduced [5]. Our center utilized the open gastric pull-up method after esophagectomy in esophageal cancer treatment until May 2008. Conventional open Original Article Korean Journal of Clinical Oncology 2018;14:95-101 https://doi.org/10.14216/kjco.18017 pISSN 1738-8082 ∙ eISSN 2288-4084