, Volume 25, Issue 3, pp 981-982
Date: 22 Jul 2010

Minimally invasive esophagectomy

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The current standard of care in the surgical treatment of early-stage esophageal cancer is complete resection of the primary tumor and regional lymph nodes (R0 resection). However, this classic open esophagectomy may be associated with increased postoperative morbidity and mortality. How can postoperative complications be reduced and quality of life improved with oncologic outcomes equal to those for open surgery?

In an effort to improve clinical outcomes, Cadière et al. [1] reported in the June issue of Surgical Endoscopy the technique of Ivor Lewis esophagectomy using a minimally invasive approach. For manual esophagogastric anastomosis by thoracoscopy and laparoscopy, the authors selected a 51-year-old man with an adenocarcinoma of the distal esophagus but no clinical evidence of lymph nodes metastasis.

The surgical procedure included three stages. In stage 1, the patient was placed in the supine position, and five abdominal trocars were placed. Celiac lymphadenectomy was performed wi