Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2016

Open Access 01-12-2016 | Research

Optimized total thoracoscopic and laparoscopic esophagectomy for esophageal cancer

Authors: Shao-hui Zhou, Yong-bin Song, Li-jun Liu, Hong-shang Cui

Published in: World Journal of Surgical Oncology | Issue 1/2016

Login to get access

Abstract

Background

Total thoracoscopic and laparoscopic esophagectomy (TLE) has attracted attention with the advantage of better operative field and minimal wound for the esophageal cancer. However, various severe complications are also reported during the TLE such as cervical anastomotic leakage, chylothorax, and tracheal injury. The aim of this study was to introduce a new optimized TLE procedure for the esophageal cancer and assess its safety and clinical effects.

Methods

We retrospectively collected the clinical data of 30 patients with esophageal cancer who underwent optimized TLE procedures between January 2014 and December 2014. The optimized TLE procedures mainly include as follows: (1) 50 ml of sesame oil-milk mixture (1:1) is injected via gastric tube after endotracheal intubation; (2) patients are intubated with a single lumen endotracheal tube; (3) patients were positioned at 150° in the left prone position rather than lateral decubitus position; and (4) duodenal feeding tube was not placed intraoperatively and however triple lumen nasojejunal feeding tube was placed on the second postoperative day under imaging guidance. Operation time, amount of blood loss, number of dissected nodes, length of hospital stays, and complications were recorded.

Results

The mean operation time of the optimized TLE group was 202.13 ± 13.74 min. The mean visible blood loss of the optimized TLE group was 300.00 ± 120.12 ml. The postoperative hospital stays in the optimized TLE group were 16.27 ± 4.51 days. The number of dissected nodes in the optimized TLE group was 13.57 ± 2.76. The postoperative complications for the optimized TLE procedure were seen in one case (3.3 %).

Conclusions

The method of optimized TLE is an effective, reliable, and safe procedure for the treatment of esophageal cancer, which provide favorable outcomes in terms of operation time, blood loss, length of hospital stays, the number the dissected nodes, and reduced incidence of postoperative complications compared to previous literatures. Further studies with a large number of samples are warranted.
Literature
1.
go back to reference Mao T, Fang W, Gu Z, Guo X, Ji C, Chen W. Comparison of perioperative outcomes between open and minimally invasive esophagectomy for esophageal cancer. Thorac Cancer. 2015;6(3):303–6.CrossRefPubMedPubMedCentral Mao T, Fang W, Gu Z, Guo X, Ji C, Chen W. Comparison of perioperative outcomes between open and minimally invasive esophagectomy for esophageal cancer. Thorac Cancer. 2015;6(3):303–6.CrossRefPubMedPubMedCentral
3.
go back to reference Bailey SH, Bull DA, Harpole DH, Rentz JJ, Neumayer LA, Pappas TN, et al. Outcomes after esophagectomy: a ten-year prospective cohort. Ann Thorac Surg. 2003;75(1):217–22. discussion 22.CrossRefPubMed Bailey SH, Bull DA, Harpole DH, Rentz JJ, Neumayer LA, Pappas TN, et al. Outcomes after esophagectomy: a ten-year prospective cohort. Ann Thorac Surg. 2003;75(1):217–22. discussion 22.CrossRefPubMed
5.
go back to reference Jamieson GG, Mathew G, Ludemann R, Wayman J, Myers JC, Devitt PG. Postoperative mortality following oesophagectomy and problems in reporting its rate. Br J Surg. 2004;91(8):943–7. doi:10.1002/bjs.4596.CrossRefPubMed Jamieson GG, Mathew G, Ludemann R, Wayman J, Myers JC, Devitt PG. Postoperative mortality following oesophagectomy and problems in reporting its rate. Br J Surg. 2004;91(8):943–7. doi:10.​1002/​bjs.​4596.CrossRefPubMed
6.
go back to reference Blazeby JM, Farndon JR, Donovan J, Alderson D. A prospective longitudinal study examining the quality of life of patients with esophageal carcinoma. Cancer. 2000;88(8):1781–7.CrossRefPubMed Blazeby JM, Farndon JR, Donovan J, Alderson D. A prospective longitudinal study examining the quality of life of patients with esophageal carcinoma. Cancer. 2000;88(8):1781–7.CrossRefPubMed
9.
go back to reference Schwameis K, Ba-Ssalamah A, Wrba F, Birner P, Prager G, Hejna M, et al. The implementation of minimally-invasive esophagectomy does not impact short-term outcome in a high-volume center. Anticancer Res. 2013;33(5):2085–91.PubMed Schwameis K, Ba-Ssalamah A, Wrba F, Birner P, Prager G, Hejna M, et al. The implementation of minimally-invasive esophagectomy does not impact short-term outcome in a high-volume center. Anticancer Res. 2013;33(5):2085–91.PubMed
16.
go back to reference Sarkaria IS, Rizk NP, Finley DJ, Bains MS, Adusumilli PS, Huang J, et al. Combined thoracoscopic and laparoscopic robotic-assisted minimally invasive esophagectomy using a four-arm platform: experience, technique and cautions during early procedure development. Eur J Cardiothorac Surg. 2013;43(5):e107–15. doi:10.1093/ejcts/ezt013.CrossRefPubMed Sarkaria IS, Rizk NP, Finley DJ, Bains MS, Adusumilli PS, Huang J, et al. Combined thoracoscopic and laparoscopic robotic-assisted minimally invasive esophagectomy using a four-arm platform: experience, technique and cautions during early procedure development. Eur J Cardiothorac Surg. 2013;43(5):e107–15. doi:10.​1093/​ejcts/​ezt013.CrossRefPubMed
17.
go back to reference Kinjo Y, Kurita N, Nakamura F, Okabe H, Tanaka E, Kataoka Y, et al. Effectiveness of combined thoracoscopic-laparoscopic esophagectomy: comparison of postoperative complications and midterm oncological outcomes in patients with esophageal cancer. Surg Endosc. 2012;26(2):381–90. doi:10.1007/s00464-011-1883-y.CrossRefPubMed Kinjo Y, Kurita N, Nakamura F, Okabe H, Tanaka E, Kataoka Y, et al. Effectiveness of combined thoracoscopic-laparoscopic esophagectomy: comparison of postoperative complications and midterm oncological outcomes in patients with esophageal cancer. Surg Endosc. 2012;26(2):381–90. doi:10.​1007/​s00464-011-1883-y.CrossRefPubMed
19.
go back to reference Nguyen NT, Follette DM, Wolfe BM, Schneider PD, Roberts P, Goodnight Jr JE. Comparison of minimally invasive esophagectomy with transthoracic and transhiatal esophagectomy. Arch Surg. 2000;135(8):920–5.CrossRefPubMed Nguyen NT, Follette DM, Wolfe BM, Schneider PD, Roberts P, Goodnight Jr JE. Comparison of minimally invasive esophagectomy with transthoracic and transhiatal esophagectomy. Arch Surg. 2000;135(8):920–5.CrossRefPubMed
20.
go back to reference Kubo N, Ohira M, Yamashita Y, Sakurai K, Toyokawa T, Tanaka H, et al. The impact of combined thoracoscopic and laparoscopic surgery on pulmonary complications after radical esophagectomy in patients with resectable esophageal cancer. Anticancer Res. 2014;34(5):2399–404.PubMed Kubo N, Ohira M, Yamashita Y, Sakurai K, Toyokawa T, Tanaka H, et al. The impact of combined thoracoscopic and laparoscopic surgery on pulmonary complications after radical esophagectomy in patients with resectable esophageal cancer. Anticancer Res. 2014;34(5):2399–404.PubMed
22.
go back to reference Guo W, Ma X, Yang S, Zhu X, Qin W, Xiang J, et al. Combined thoracoscopic-laparoscopic esophagectomy versus open esophagectomy: a meta-analysis of outcomes. Surg Endosc. 2015. doi:10.1007/s00464-015-4692-x. Guo W, Ma X, Yang S, Zhu X, Qin W, Xiang J, et al. Combined thoracoscopic-laparoscopic esophagectomy versus open esophagectomy: a meta-analysis of outcomes. Surg Endosc. 2015. doi:10.​1007/​s00464-015-4692-x.
23.
go back to reference Pattijn P, Ceelen W, Gillardin J, Van de Putte D, Boterberg T, Peeters M. Results of Ivor Lewis esophagectomy for mid and distal esophageal cancer. J Clin Gastroenterol. 2006;40:S175.CrossRef Pattijn P, Ceelen W, Gillardin J, Van de Putte D, Boterberg T, Peeters M. Results of Ivor Lewis esophagectomy for mid and distal esophageal cancer. J Clin Gastroenterol. 2006;40:S175.CrossRef
27.
28.
30.
go back to reference Fahimi H, Casselman FP, Mariani MA, van Boven WJ, Knaepen PJ, van Swieten HA. Current management of postoperative chylothorax. Ann Thorac Surg. 2001;71(2):448–50. discussion 50–1.CrossRefPubMed Fahimi H, Casselman FP, Mariani MA, van Boven WJ, Knaepen PJ, van Swieten HA. Current management of postoperative chylothorax. Ann Thorac Surg. 2001;71(2):448–50. discussion 50–1.CrossRefPubMed
31.
go back to reference Kumar S, Kumar A, Pawar DK. Thoracoscopic management of thoracic duct injury: is there a place for conservatism? J Postgrad Med. 2004;50(1):57–9.PubMed Kumar S, Kumar A, Pawar DK. Thoracoscopic management of thoracic duct injury: is there a place for conservatism? J Postgrad Med. 2004;50(1):57–9.PubMed
Metadata
Title
Optimized total thoracoscopic and laparoscopic esophagectomy for esophageal cancer
Authors
Shao-hui Zhou
Yong-bin Song
Li-jun Liu
Hong-shang Cui
Publication date
01-12-2016
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2016
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-016-0824-6

Other articles of this Issue 1/2016

World Journal of Surgical Oncology 1/2016 Go to the issue