Minimally invasive surgery in esophageal cancer
Tayfun Karahasanoğlu1, İsmail Hamzaoğlu1, Bilgi Baca1, Yeliz Ersoy1, Kamil Kaynak2, Murat Akçıl 2, Feridun Şirin1
1 İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Genel Cerrahi AD, İSTANBUL
2 İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Göğüs Cerrahisi AD, İSTANBUL
Purpose: The aim of this study is to evaluate the results of minimally invasive surgical approach in the treatment of the patients who have esophageal cancer.
Materials and Methods: Between May 2003 and February 2007, nine consecutive patients underwent minimally invasive surgery for esophageal cancer by a single surgical team. Surgical technique, operative data and short term results were asssessed.
Results: There were five male and four female patients with a mean age of 55 (29-74) years. Esophageal tumor localization sites were upper third in three, middle third in four, lower third in two patients. Three staged operation was performed in all patients, except one (right thoracoscopy or thoracotomy, laparoscopy or laparotomy, cervical anastomosis). Laparoscopic transhiatal esophagectomy was done in one patient. Gastric conduit was used in eight patients whereas left colon interposition in one patient for reconstruction. One patient who underwent a left colonic interposition died on the postoperative day 11 because of aspiration pneumonia. Hoarseness developed in one patient caused by recurrent nerve injury. Mean operation time was 270 (210-360) minutes. All patients, except two were followed in the surgery service. Mean postoperative hospital stay was 11 (7-18) days. Mean follow-up time was 11 (1-35) months. There was no recurrence during follow-up.
Conclusion: Minimally invasive esophagectomy is a reliable procedure with advantages of minimally invasive surgery. Effective oncological resection can be done. We think that it will be a good alternative procedure over conventional esophagectomy with an increased experience.
Keywords: Thoracoscopic esophagectomy, esophagus cancer, minimal invasive esophagectomy, thoraco-laparoscopy, laparoscopy.