Zentralblatt fur Chirurgie · 2009
[Intrathoracic thoracoscopic anastomosis in minimally invasive oesophageal resection - technical tips].
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Böttger T, Müller M, Hermeneit S, Rodehorst A
Аннотация
INTRODUCTION: Minimally invasive oesophageal resections are being increasingly propagated. However, a leakage of the cervical anastomosis, occurring in up to 30 % of the cases, remains a severe disadvantage. By means of a case report, a new alternative technique of intrathoracic thoracoscopic anastomosis is described.
PATIENT AND METHOD: After the customary laparoscopic abdominal performance of lymph-node dissection, a gastric conduit was performed in a 73-year-old patient with an adenocarcinoma of the gastro-oesophageal junction. After that the oesophagus had been resected thoracoscopically and an intrathoracic side-to-side/functional end-to-end anastomosis between the gastric conduit and oesophagus was performed with linear staplers.
RESULTS: There were no postoperative complications.
CONCLUSION: The intrathoracic thoracoscopic oesophagogastrostomy seems to be an oncologically adequate procedure that has less complications than the other laparoscopic-thoracoscopic techniques described so far. However, further studies are necessary to prove this conclusively.
PATIENT AND METHOD: After the customary laparoscopic abdominal performance of lymph-node dissection, a gastric conduit was performed in a 73-year-old patient with an adenocarcinoma of the gastro-oesophageal junction. After that the oesophagus had been resected thoracoscopically and an intrathoracic side-to-side/functional end-to-end anastomosis between the gastric conduit and oesophagus was performed with linear staplers.
RESULTS: There were no postoperative complications.
CONCLUSION: The intrathoracic thoracoscopic oesophagogastrostomy seems to be an oncologically adequate procedure that has less complications than the other laparoscopic-thoracoscopic techniques described so far. However, further studies are necessary to prove this conclusively.