Minimally invasive 3-field esophagectomy with cervical single-port access.

BACKGROUND

Minimally invasive esophagectomy for esophageal cancer include thoracoscopic and laparoscopic esophagectomy with a cervical single-port assist, which is inadequate for both techniques. This is the first reported series applying this technique to treat esophageal cancer patients in literature.

MATERIALS AND

METHODS

From March 2007 to April 2011, 12 cases of laparoscopic and thoracoscopic total esophagectomy with a cervical single-port assist were performed. Indications for minimally invasive esophagectomy included esophageal squamous cell carcinoma, diagnosed preoperatively in nonmetastatic tumors and fewer than 4 lymph nodes by endoscopic ultrasonography.

RESULTS

The mean operative time was 440 minutes (range, 347 to 578 min). The mean intensive care stay was 1.6 days (range, 0 to 6 d). The mean hospital stay was 11.8 days (range, 7 to 22 d). Minor complications included atrial fibrillation (n=1), pleural effusion (n=2), and persistent air leaks (n=1), and major complications included cervical anastomotic leak in 1 patient due to technical failure. The 30-day mortality rate was 0.

CONCLUSIONS

Video-assisted thoracoscopic and laparoscopic esophagectomy combined with a cervical single-port assist is a safe and minimally invasive technique for whole esophagus and mediastinal lymph node dissection. This technique allows for the clear visualization of the mediastinum, reducing the risk of surgery-related trauma.