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01-11-2011 | Original Article

Significance of Thoracoscopy-Assisted Surgery with a Minithoracotomy and Hand-Assisted Laparoscopic Surgery for Esophageal Cancer: The Experience of a Single Surgeon

Authors: Chikara Kunisaki, Takashi Kosaka, Hidetaka A. Ono, Takashi Oshima, Shoichi Fujii, Ryo Takagawa, Jun Kimura, Motohiko Tokuhisa, Yusuke Izumisawa, Hirochika Makino, Hirotoshi Akiyama, Itaru Endo

Published in: Journal of Gastrointestinal Surgery | Issue 11/2011

Abstract

Background

This retrospective study evaluated the surgical learning curve and outcomes of thoracolaparoscopic esophagectomy.

Patients and Methods

The study group comprised a series of 92 patients with preoperatively diagnosed resectable thoracic esophageal cancer. Additionally, the surgical outcomes in 79 esophageal cancer patients receiving open esophagectomies were compared. All patients underwent thoracolaparoscopic esophagectomy in the lateral decubitus position. The short- and long-term outcomes were evaluated, and the surgical learning curve was assessed.

Results

The total operation time was 477.8 ± 102.2 min, the thoracoscopic time was 157.9 ± 61.3 min, the total blood loss was 554.4 ± 280.5 ml, and the number of retrieved lymph nodes was 34.3 ± 14.3. Postoperative morbidity was observed in 23 patients. After the surgeon’s first 40 cases, the surgical technique and short-term outcomes were stable. The 5-year disease-specific survival was 66.6% and the 5-year overall survival was 64.6% in patients receiving R0 thoracolaparoscopic esophagectomy. Comparison of 5-year disease-specific survival rate according to tumor–node–metastasis stage between patients receiving R0 thoracolaparoscopic esophagectomy and conventional open esophagectomy showed that there were no significant differences in survival in any stage between the two groups. Loco-regional recurrence was observed in 6 patients, distant recurrence in seven, and combined recurrence in nine after R0 thoracolaparoscopic esophagectomy. There was no significant difference in the pattern of recurrence between the two groups.

Conclusions

Thoracolaparoscopic esophagectomy for esophageal cancer was technically feasible and oncologically satisfactory, according to the surgical learning curve.

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Title: Significance of Thoracoscopy-Assisted Surgery with a Minithoracotomy and Hand-Assisted Laparoscopic Surgery for Esophageal Cancer: The Experience of a Single Surgeon
Authors: Chikara Kunisaki
Takashi Kosaka
Hidetaka A. Ono
Takashi Oshima
Shoichi Fujii
Ryo Takagawa
Jun Kimura
Motohiko Tokuhisa
Yusuke Izumisawa
Hirochika Makino
Hirotoshi Akiyama
Itaru Endo
Publication date: 01-11-2011
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 11/2011
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-011-1664-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Significance of Thoracoscopy-Assisted Surgery with a Minithoracotomy and Hand-Assisted Laparoscopic Surgery for Esophageal Cancer: The Experience of a Single Surgeon

Abstract

Background

Patients and Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and Methods

Results

Conclusions

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