title: Minimal invasive approach of gastric and esophageal mobilization in total pharyngolaryngoesophagectomy: total laparoscopic and hand-assisted laparoscopic technique.
abstract: 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.
authors.affiliation: Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.
authors.forename: S K H
authors.initials: SK
authors.lastname: Wong
authors.forename: A C W
authors.initials: AC
authors.lastname: Chan
authors.forename: D W H
authors.initials: DW
authors.lastname: Lee
authors.forename: E W H
authors.initials: EW
authors.lastname: To
authors.forename: E K W
authors.initials: EK
authors.lastname: Ng
authors.forename: S C S
authors.initials: SC
authors.lastname: Chung
mesh_terms: 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