[Transthoracic and transhiatal esophagectomy using minimally invasive techniques. Experience in 50 patients].
BACKGROUND
Minimally invasive esophagectomy (MIE) can reduce surgical aggression and cardiopulmonary complications while maintaining basic oncological principles. We present the results of our initial experience with this technique in the treatment of esophageal cancer.


METHODS
Fifty patients with a diagnosis of esophageal cancer were selected to undergo MIE. In 18 patients the tumour was located in supracarinal esophagus, in 24 in subcarinal esophagus and in 8 patients in the cardial region. The surgical procedures were: three-field esophagectomy (laparoscopy, thoracostomy and cervicotomy), transhiatal esophagectomy and Ivor Lewis procedure (thoracoscopy and laparoscopy).


RESULTS
The laparoscopy approach was used in 48 patients and 13 by the thoracoscopy approach. Transhiatal esophagectomy was performed on 13 patients. The mean duration of intervention was 281 minutes. Morbidity was 48% and mortality was 8%. The mean hospital stay was 13.2 days. Survival analysis showed: 82% in stage I, 38% in stage II and 24% in stage III. The mean follow-up was 19 months.


CONCLUSIONS
Minimally invasive techniques to resect the esophagus in patients with cancer were confirmed to be safe and comparable to an open approach with respect to postoperative recovery and cancer survival.
Roig-García
José
J
Unidad de Cirugía Esofagogástrica, Hospital Universitario Dr J Trueta, Girona, España. jroigg@ono.com
Gironés-Vilà
Jordi
J
Garsot-Savall
Elisenda
E
Puig-Costa
Manel
M
Rodríguez-Hermosa
José
J
Codina-Cazador
Antoni
A
D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013906:Thoracoscopy; D013907:Thoracostomy