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Mesenteric excision for esophageal cancer surgery: based on the concept of mesotracheoesophagus

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Abstract

The fundamental principle of surgery for intestinal cancer is mesenteric excision. It has been widely accepted as radical surgery for colorectal cancer, and it comprises procedures such as complete mesocolic excision for colon cancer and total mesorectal excision for rectal cancer. So far, the concept of mesenteric excision of the esophagus has not been well documented, but our surgical experience with a magnified view using a thoracoscope and understanding of the surgical anatomy based on embryologic foregut development has led us to introduce the concept of mesotracheoesophagus. Using this concept, our technique is reproducible, effective, and safe for lymph node dissection along the left recurrent laryngeal nerve. Here we report our concept, procedure, and results of thoracoscopic esophageal cancer surgery.

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References

  1. Heald RJ, Husband EM, Ryall RD (1982) The mesorectum in rectal cancer surgery–the clue to pelvic recurrence? Br J Surg 69(10):613–616

    Article  CAS  PubMed  Google Scholar 

  2. Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S (2009) Standardized surgery for colonic cancer: complete mesocolic excision and central ligation–technical notes and outcome. Colorectal Dis 11(4):354–364

    Article  CAS  PubMed  Google Scholar 

  3. Borghi F, Gattolin A, Bogliatto F, Garavoglia M, Levi AC (2002) Relationships between gastric development and anatomic bases of radical surgery for cancer. World J Surg 26(9):1139–1144

    Article  PubMed  Google Scholar 

  4. Shinohara H, Kurahashi Y, Haruta S, Ishida Y, Sasako M (2018) Universalization of the operative strategy by systematic mesogastric excision for stomach cancer with that for total mesorectal excision and complete mesocolic excision colorectal counterparts. Ann Gastroenterol Surg 2(1):28–36

    Article  PubMed  Google Scholar 

  5. Cuesta MA, Weijs TJ, Bleys RL, van Hillegersberg R, van Berge Henegouwen MI, Gisbertz SS et al (2015) A new concept of the anatomy of the thoracic oesophagus: the meso-oesophagus. Observational study during thoracoscopic esophagectomy. Surg Endosc 29(9):2576–2582

    Article  PubMed  Google Scholar 

  6. Cuesta MA, van der Wielen N, Weijs TJ, Bleys RL, Gisbertz SS, van Duijvendijk P et al (2017) Surgical anatomy of the supracarinal esophagus based on a minimally invasive approach: vascular and nervous anatomy and technical steps to resection and lymphadenectomy. Surg Endosc 31(4):1863–1870

    Article  PubMed  Google Scholar 

  7. Sarrazin R, Voog R (1971) Anatomical background to mediastinoscopy. In: Jepsen O, Sørensen HR (eds) Mediastinoscopy. Odense University Press, Odense, pp 1–6

    Google Scholar 

  8. Heald RJ, Ryall RD (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1(8496):1479–1482

    Article  CAS  PubMed  Google Scholar 

  9. Kapiteijn E, Putter H, van de Velde CJ (2002) Impact of the introduction and training of total mesorectal excision on recurrence and survival in rectal cancer in The Netherlands. Br J Surg 89(9):1142–1149

    Article  CAS  PubMed  Google Scholar 

  10. Heald RJ (1988) The ‘Holy Plane’ of rectal surgery. J R Soc Med 81(9):503–508

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Uyama I, Sugioka A, Matsui H, Fujita J, Komori Y, Hasumi A (2000) Laparoscopic D2 lymph node dissection for advanced gastric cancer located in the middle or lower third portion of the stomach. Gastr Cancer Off J Int Gastr Cancer Assoc Jpn Gastr Cancer Assoc 3(1):50–55

    Google Scholar 

  12. Noshiro H, Nagai E, Shimizu S, Uchiyama A, Tanaka M (2005) Laparoscopically assisted distal gastrectomy with standard radical lymph node dissection for gastric cancer. Surg Endosc 19(12):1592–1596

    Article  CAS  PubMed  Google Scholar 

  13. Katai H, Sasako M, Fukuda H, Nakamura K, Hiki N, Saka M et al (2010) Safety and feasibility of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG 0703). Gastr Cancer Off J Int Gastr Cancer Assoc Jpn Gastr Cancer Assoc 13(4):238–244

    Google Scholar 

  14. Sutliff KS, Hutchins GM (1994) Septation of the respiratory and digestive tracts in human embryos: crucial role of the tracheoesophageal sulcus. Anat Rec 238(2):237–247

    Article  CAS  PubMed  Google Scholar 

  15. Kluth D, Fiegel H (2003) The embryology of the foregut. Semin Pediatr Surg 12(1):3–9

    Article  PubMed  Google Scholar 

  16. Oshikiri T, Yasuda T, Harada H, Goto H, Oyama M, Hasegawa H et al (2015) A new method (the “Bascule method”) for lymphadenectomy along the left recurrent laryngeal nerve during prone esophagectomy for esophageal cancer. Surg Endosc 29(8):2442–2450

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Osaka Red Cross Hospital, Osaka, Japan

    Shin Akagawa, Hisahiro Hosogi, Fumihiro Yoshimura, Hironori Kawada & Seiichiro Kanaya

  2. Department of Surgery, Kyoto City Hospital, Kyoto, Japan

    Hisahiro Hosogi

  3. Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan

    Fumihiro Yoshimura

  4. Department of Gastroenterological Surgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan

    Hironori Kawada

Authors
  1. Shin Akagawa
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  2. Hisahiro Hosogi
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  3. Fumihiro Yoshimura
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  4. Hironori Kawada
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  5. Seiichiro Kanaya
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Contributions

Study conception and design: SK. Drafting of manuscript: SA and HH. Critical revision of manuscript: FY, HK, and SK.

Corresponding author

Correspondence to Shin Akagawa.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from the patient for publication of this video article and any accompanying images.

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Akagawa, S., Hosogi, H., Yoshimura, F. et al. Mesenteric excision for esophageal cancer surgery: based on the concept of mesotracheoesophagus. Int Canc Conf J 7, 117–120 (2018). https://doi.org/10.1007/s13691-018-0329-y

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  • DOI: https://doi.org/10.1007/s13691-018-0329-y

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