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Surgical Endoscopy
Published in: Surgical Endoscopy 8/2004

01-08-2004 | Original article

Anesthesiological hazards during laparoscopic transhiatal esophageal resection: a case control study of the laparoscopic-assisted vs the conventional approach

Authors: Ö. Makay, W. T. van den Broek, J. Z. Yuan, D. P. Veerman, D. W. H. Helfferich, M. A. Cuesta

Published in: Surgical Endoscopy | Issue 8/2004

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Abstract

Background

Interest for minimal invasive approach of esophagus resection is increasing. Today, a minimally invasive transhiatal esophagectomy is possible and is accepted widespread. Since cardiopulmonary changes during laparoscopic dissection of the mediastinum has not been studied yet we assessed the anesthesiological consequences of pneumothorax during laparoscopic mediastinal dissection.

Methods

In this case control study, 25 laparoscopically assisted transhiatal espohagus resections were compared with a control group consisting of 20 open transhiatal esophagus resections. Patient characteristics and intraoperative haemodynamic, respiratory, and ventilatory parameters were assessed.

Results

The laparoscopic assisted procedure was performed successfully in 12 of the 20 patients. The duration of the laparoscopic assisted procedure, compared to the open group was significantly longer (p<0.05). Intraoperative blood loss was significantly less in the laparoscopic group (p<0.05). Mediastinal dissection resulted in entry of the pleura in 84% of the open and 93% of the laparoscopic assisted procedure. Carbondioxide pneumothorax resulted in increased end-tidal CO2 and airway pressure levels and decreased lunng compliance. Airway pressure showed a significant difference between the groups (p<0.05). Hemodynamic parameters did not differ between groups significantly. There were no differences in postoperative cardiopulmonary complications.

Conclusions

Laparoscopic assisted transhiatal esophagectomy is a safe procedure and has no increased risk of postoperative cardiopulmonary complications compared to thr conventional approach. The anesthesiologist and the surgeon must be aware of the potential risk of pleural injury to manage cardiopulmonary compromises and minimize complications.
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Metadata
Title
Anesthesiological hazards during laparoscopic transhiatal esophageal resection: a case control study of the laparoscopic-assisted vs the conventional approach
Authors
Ö. Makay
W. T. van den Broek
J. Z. Yuan
D. P. Veerman
D. W. H. Helfferich
M. A. Cuesta
Publication date
01-08-2004
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 8/2004
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-003-9176-8

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