A laparoscopy-assisted surgical approach to esophageal carcinoma

Luigi Bonavina, Davide Bona, Pierre René Binyom, Alberto Peracchia

Research output: Contribution to journalArticle

Abstract

Background Surgical resection is the treatment of choice for esophageal carcinoma. Over the past decade, laparoscopy has proven an accurate staging modality for detecting peritoneal carcinosis and small metastatic liver deposits unsuspected at preoperative investigation. This has led to a change in surgical strategy in up to 20% of patients. In addition, by means of laparoscopic techniques, it is possible to mobilize the stomach and perform a safe transhiatal mediastinal dissection at least up to the level of the inferior pulmonary veins. Patients and methods Laparoscopy-assisted esophagectomy was attempted in 43 patients over the past 3 years. The esophagectomy was performed via laparoscopy combined with right thoracotomy (group A) or with left cervicotomy and transmediastinal endodissection (group B). Results The overall conversion rate to laparotomy was 11.6%. No hospital deaths occurred. The morbidity rate was 20% in group A and 30.7% in group B. The mean hospital stay was 11 in group A and 10 days in group B. Five patients died between 11 and 19 months after surgery with recurrent disease. No port-site metastases were recorded during follow-up. Conclusions This approach has proven feasible and safe in the medium-term follow-up. Further experience and a longer follow-up are needed to assess the impact of these procedures on long-term survival.

Original languageEnglish
Pages (from-to)52-57
Number of pages6
JournalJournal of Surgical Research
Volume117
Issue number1
DOIs
Publication statusPublished - Mar 2004

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Laparoscopy
Carcinoma
Esophagectomy
Pulmonary Veins
Thoracotomy
Laparotomy
Dissection
Length of Stay
Stomach
Neoplasm Metastasis
Morbidity
Survival
Liver
Therapeutics

Keywords

  • Barrett's esophagus
  • Esophageal carcinoma
  • Esophagectomy
  • Esophagus
  • Laparoscopy
  • Staging

ASJC Scopus subject areas

  • Surgery

Cite this

A laparoscopy-assisted surgical approach to esophageal carcinoma. / Bonavina, Luigi; Bona, Davide; Binyom, Pierre René; Peracchia, Alberto.

In: Journal of Surgical Research, Vol. 117, No. 1, 03.2004, p. 52-57.

Research output: Contribution to journalArticle

Bonavina, Luigi ; Bona, Davide ; Binyom, Pierre René ; Peracchia, Alberto. / A laparoscopy-assisted surgical approach to esophageal carcinoma. In: Journal of Surgical Research. 2004 ; Vol. 117, No. 1. pp. 52-57.
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