Minimal invasive approach of gastric and esophageal mobilization in total pharyngolaryngoesophagectomy: total laparoscopic and hand-assisted laparoscopic technique.
BACKGROUND
To evaluate early results in total pharyngolaryngoesophagectomy (PLE) by minimally invasive approaches for patients suffered from pharyngoesophageal tumor.


METHODS
Between April 1998 and September 2001, 12 consecutive patients underwent either total laparoscopic (n = 9) or hand-assisted laparoscopic (n = 3) gastric mobilization plus transhiatal esophageal resection in total PLE. The operative data and postoperative outcomes were evaluated.


RESULTS
Total PLE by minimally invasive approach was successfully performed in 11 patients, and 1 patient required conversion due to uncontrolled bleeding. The median total operative time was 8.5 h (range, 5-11 h) and the abdominal laparoscopic stage usually took less than 4 h. The median time for extubation was 2 days (range, 1-4 days) and the median ICU stay was 2 days (range, 1-20 days). There was no 30-day mortality, and major complications occurred in 5 patients (42%).


CONCLUSIONS
Minimally invasive PLE is a feasible and safe alternative to conventional open surgery for patients with pharyngoesophageal carcinoma.
Wong
S K H
SK
Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.
Chan
A C W
AC
Lee
D W H
DW
To
E W H
EW
Ng
E K W
EK
Chung
S C S
SC
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000601:surgery; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000601:surgery; D016629:Esophagectomy / Q000379:methods*; D004947:Esophagus / Q000601:surgery*; D006488:Hemostasis, Surgical; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000601:surgery; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010610:Pharyngeal Neoplasms / Q000453:epidemiology / Q000601:surgery; D010611:Pharyngectomy / Q000379:methods*; D013270:Stomach / Q000601:surgery*; D017792:Surgical Stapling