title: Minimally invasive esophagogastrectomy for esophagogastric junctional cancer.
abstract: BACKGROUND
  Because surgery for esophagogastric junctional cancer (EGJC) occasionally requires a thoracotomy in addition to a laparotomy, surgery is associated with high mortality and morbidity rates. Therefore, minimally invasive surgery should be developed as an alternative to conventional open surgery.
  
  
  METHODS
  We herein describe our first series of seven patients with EGJC who were treated by minimally-invasive surgery using thoracoscopy in addition to the laparoscopic procedure. During the thoracoscopic procedures, transection of the esophagus was performed at the cancer-free portion with a dissection of lower mediastinal nodes and a side-to-side Roux-en-Y esophagojejunostomy was made intrathoracically.
  
  
  RESULTS
  In the seven patients treated using this procedure, the mean total length of the operation was 606 minutes and the mean number of retrieved lymph nodes was 58. No adverse events occurred intraoperatively and no failure in the intrathoracic esophagojejunostomy was observed, and favorable short-term results were obtained.
  
  
  CONCLUSIONS
  The described procedure for the treatment of patients with EGJC is a minimally invasive alternative to conventional open surgery that looks promising.
authors: Department of Surgery, Faculty of Medicine, Saga University, Saga, Japan. noshiro@cc.saga-u.ac.jp
authors: Hirokazu
authors: H
authors: Noshiro
authors: Yoshihiro
authors: Y
authors: Miyasaka
authors: Michiaki
authors: M
authors: Akashi
authors: Hironori
authors: H
authors: Iwasaki
authors: Osamu
authors: O
authors: Ikeda
authors: Akihiko
authors: A
authors: Uchiyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016629:Esophagectomy; D004943:Esophagogastric Junction / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D007564:Japan / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery*; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000601:surgery*; D015996:Survival Rate / Q000639:trends; D013906:Thoracoscopy / Q000379:methods*; D016896:Treatment Outcome