title: Minimally invasive 3-field esophagectomy with cervical single-port access.
abstract: BACKGROUND
  Minimally invasive esophagectomy for esophageal cancer include thoracoscopic and laparoscopic esophagectomy with a cervical single-port assist, which is inadequate for both techniques. This is the first reported series applying this technique to treat esophageal cancer patients in literature.
  
  
  METHODS
  From March 2007 to April 2011, 12 cases of laparoscopic and thoracoscopic total esophagectomy with a cervical single-port assist were performed. Indications for minimally invasive esophagectomy included esophageal squamous cell carcinoma, diagnosed preoperatively in nonmetastatic tumors and fewer than 4 lymph nodes by endoscopic ultrasonography.
  
  
  RESULTS
  The mean operative time was 440 minutes (range, 347 to 578 min). The mean intensive care stay was 1.6 days (range, 0 to 6 d). The mean hospital stay was 11.8 days (range, 7 to 22 d). Minor complications included atrial fibrillation (n=1), pleural effusion (n=2), and persistent air leaks (n=1), and major complications included cervical anastomotic leak in 1 patient due to technical failure. The 30-day mortality rate was 0.
  
  
  CONCLUSIONS
  Video-assisted thoracoscopic and laparoscopic esophagectomy combined with a cervical single-port assist is a safe and minimally invasive technique for whole esophagus and mediastinal lymph node dissection. This technique allows for the clear visualization of the mediastinum, reducing the risk of surgery-related trauma.
authors.affiliation: Departments of *Surgery †Thoracic Surgery, OkmeydaniTraining and Research Hospital ‡Department of Surgery, Istanbul University, School of Medicine, Istanbul, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Guven
authors.forename: Servet R
authors.initials: SR
authors.lastname: Karahan
authors.forename: Bora
authors.initials: B
authors.lastname: Koc
authors.forename: Volkan
authors.initials: V
authors.lastname: Erdogu
authors.forename: Ayhan
authors.initials: A
authors.lastname: Ozsoy
authors.forename: Gokhan T
authors.initials: GT
authors.lastname: Adas
authors.forename: Onur
authors.initials: O
authors.lastname: Bayram
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000601:surgery*; D019160:Endosonography; D004867:Equipment Design; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000295:instrumentation*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D061646:Operative Time; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D020708:Thoracoscopes; D013906:Thoracoscopy / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome