Erschienen in:
01.08.2010 | 2009 SSAT Poster Presentation
Applicability and Feasibility of Incorporating Minimally Invasive Esophagectomy at a High Volume Center
verfasst von:
Brittany L. Willer, Sumeet K. Mittal, Stephanie G. Worrell, Seemal Mumtaz, Tommy H. Lee
Erschienen in:
Journal of Gastrointestinal Surgery
|
Ausgabe 8/2010
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Excerpt
Esophageal resection remains an integral part of treatment for esophageal cancer. Traditionally, the two open operative techniques which incorporate a cervical esophago-gastric anastomosis have been transhiatal esophagectomy (THE) and transthoracic esophagectomy, with en bloc lymphadenectomy (TTE). The clinical decision as to which of these two procedures would best serve the patient often rests on the following notion: the goal of THE is to reduce early postoperative morbidity and mortality by avoiding a thoracotomy, whereas the goal of TTE is to increase long-term survival by employing wide excision and extensive node dissection in the mediastinum and abdomen.
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2 En bloc esophagectomy has been shown to increase survival by decreasing locoregional disease recurrence related to micrometastatic disease.
3 Transhiatal esophagectomy is often associated with increased locoregional failure rates in the absence of extended lymphadenectomy and has the potential to cause significantly more bleeding than other approaches because of the blunt mediastinal dissection.
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4 Despite these concerns, THE is a valid option for patients with or at risk for respiratory disorders, as it significantly decreases perioperative pulmonary complications.
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4 …
