초록접수 현황
| 14F-266 | 구연 발표 |
The Early Experience with Minimal Invasive Ivor Lewis Operation by One Surgeon
Kim Jae Hyun M.D. , Kim Joo Hyun M.D.
Department of Thoracic surgery, Dongnam Institute of Radiological & Medical Sciences, Cancer center, Busan, Korea
Background : Althogh the esophagectomy for esophageal cancer is a challenging surgery and is associated with significant morbidity and mortality, the needs for minimally invasive approaches in the surgery for the esophageal cancer patients are required of thoracic surgeon. So we evaluated the feasibility of minimal invasive (MIS) Ivor Lewis esophagectomy by one surgeon performed in our hospital.
Methods : We retrospectively analyzed clinical data from 19 consecutive patients (esophageal cancer in 18 patients, esophageal gastrointestinal stromal tumor in one patient) undergoing MIS Ivor Lewis operation from 2011 to 2014. In 12 patients, we approached a laparoscopic mobilization of the stomach and a thoracoscopic esophageal mobilization and intrathoracic anastomosis at thoracic inlet. Seven patients underwent a laparotomy and thoracoscopic esophageal mobilization due to the past surgery.
Results : The mean age was 65 (range 52-80) with 16 male patients. There was no perioperative event or conversion to open thoracotomy. In one patient, conversion to open median laparotomy from laparoscopic surgery was needed. All patients underwent an R0 resection, and the mean number of nodes harvested was 26 (range 12-52). Mean operative time was 372 minutes (range 250-615) and one patient had anastomotic leak. Postoperative mortality occurred in one patient due to pneumonia. Any patient was no longer requiring analgesics after one month postoperatively.
Conclusion : Minimally invasive Ivor Lewis operation, although technically challenging, can be carried out with reasonable operative times, minimal complication and reduced postoperative pain. Final oncologic validity is pending longer follow-up and a large study.
Methods : We retrospectively analyzed clinical data from 19 consecutive patients (esophageal cancer in 18 patients, esophageal gastrointestinal stromal tumor in one patient) undergoing MIS Ivor Lewis operation from 2011 to 2014. In 12 patients, we approached a laparoscopic mobilization of the stomach and a thoracoscopic esophageal mobilization and intrathoracic anastomosis at thoracic inlet. Seven patients underwent a laparotomy and thoracoscopic esophageal mobilization due to the past surgery.
Results : The mean age was 65 (range 52-80) with 16 male patients. There was no perioperative event or conversion to open thoracotomy. In one patient, conversion to open median laparotomy from laparoscopic surgery was needed. All patients underwent an R0 resection, and the mean number of nodes harvested was 26 (range 12-52). Mean operative time was 372 minutes (range 250-615) and one patient had anastomotic leak. Postoperative mortality occurred in one patient due to pneumonia. Any patient was no longer requiring analgesics after one month postoperatively.
Conclusion : Minimally invasive Ivor Lewis operation, although technically challenging, can be carried out with reasonable operative times, minimal complication and reduced postoperative pain. Final oncologic validity is pending longer follow-up and a large study.
책임저자: Kim Jae Hyun
Department of Thoracic surgery, Dongnam Institute of Radiological & Medical Sciences, Cancer center, Busan, Korea
연락처 : 김재현, Tel: 051-720-5050 , E-mail : cskjh2@dirams.re.kr
