Korean J Clin Oncol.  2018 Dec;14(2):95-101. 10.14216/kjco.18017.

Experiences of thoracic esophagectomy with laparoscopic gastric pull up in thoracic esophageal cancer patient in single center

• Jun JW
• Kim W
• Park JM

• KMID: 2432606
• DOI: http://doi.org/10.14216/kjco.18017

Abstract

PURPOSE
The standard treatment of esophageal cancer is the Ivor-Lewis operation, which consists of an abdominal phase involving gastric tube formation, and a chest phase involving esophagectomy and anastomosis. We aimed to report our experience of performing thoracic esophagectomy with the laparoscopic gastric pull up (LGPU) technique and its surgical outcomes.
METHODS
Clinicopathologic data and short-term surgical outcomes of 14 patients who underwent LGPU for thoracic esophageal cancer from August 2008 to May 2016 were retrospectively reviewed.
RESULTS
Mean age of the patients was 62.3 years and mean body mass index was 21.7 kg/m2. Eleven patients had medical comorbidities. Patients' mean American Society of Anesthesiologists score was 2. Mean operation time was 428.5 minutes, with the mean abdominal operation time being 138.9 minutes. There was no open conversion case. Three patients had pneumonia, three patients had surgical site infection, and one patient had subcutaneous emphysema within 30 days after surgery. One patient had minor anastomosis site leakage. There was one 30-day mortality case. One patient with postoperative aspiration pneumonia developed acute respiratory distress disease, and died due to sepsis. Mean postoperative intensive care unit stay was 3.5 days, and mean postoperative hospital stay was 20.6 days. Nasogastric tubes were removed on average at 3.4 days, and mean oral intake time was 3.4 days.
CONCLUSION
If the gastrointestinal surgeon has extensive experience in laparoscopic procedures, LGPU will be a safe and feasible technique for thoracic esophagectomy in patients with intrathoracic esophageal cancer.

Keyword

Esophageal neoplasm; Laparoscope; Esophagectomies; Reconstructive surgical procedures

MeSH Terms

Body Mass Index
Comorbidity
Esophageal Neoplasms*
Esophagectomy*
Humans
Intensive Care Units
Laparoscopes
Length of Stay
Mortality
Pneumonia
Pneumonia, Aspiration
Reconstructive Surgical Procedures
Retrospective Studies
Sepsis
Subcutaneous Emphysema
Surgical Wound Infection
Thorax