Ann Surg Treat Res.  2015 Sep;89(3):117-123. 10.4174/astr.2015.89.3.117.

Laparoscopic gastric tube formation with pyloromyotomy for reconstruction in patients with esophageal cancer

• Lee JW
• Sung SW
• Park JK
• Park CH
• Song KY

• KMID: 2166933
• DOI: http://doi.org/10.4174/astr.2015.89.3.117

Abstract

PURPOSE
To analyze the benefit and feasibility of this procedure compared with those of open method.
METHODS
Abdominal procedure includes laparoscopic gastric mobilization, celiac axis lymph node dissection, formation of the gastric tube, and pyloromyotomy. The actual procedure performed during open surgery is the same as those of laparoscopic surgery except for the main incision. Minimally invasive esophagectomy (MIE) was performed on 54 patients with esophageal cancer. The short-term outcomes, including postoperative complications were analyzed and compared with 44 cases of open method.
RESULTS
Although the total operative time was not different between 2 groups (349.8 minutes vs. 374.8 minutes, P = 0.153), the operation time of abdominal procedure was shorter in laparoscopic group (90.6 minutes vs. 162.1 minutes, P < 0.001). Operation related complications and hospital stay were not significantly different between the 2 groups. The number of transfused patients was significantly smaller in laparoscopic group (11.1% vs. 27.9%, P = 0.030).
CONCLUSION
Laparoscopic gastric tubing with pyloromyotomy is a feasible and safe treatment option for patients with esophageal cancer.

Keyword

Esophageal cancer; Minimally invasive surgical procedures; Laparoscopy; Feasibility studies

MeSH Terms

Axis, Cervical Vertebra
Esophageal Neoplasms*
Esophagectomy
Feasibility Studies
Humans
Laparoscopy
Length of Stay
Lymph Node Excision
Operative Time
Postoperative Complications
Surgical Procedures, Minimally Invasive

Figure

• 

  Fig. 1 (A) Trocar placement. (B) Lymph node dissection around celiac axis. (C) Gastric tube formation using stapler. (D) Pyloromyotomy using monopolar cautery. LGA, left gastric artery; CHA, common hepatic artery; SA, splenic artery.

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