Esophagectomy technique with supported thoracoscopy

Background: Esophageal cancer is a common disease at Digestive Surgery Department of Binh Dan hospital. Surgical treatment is still a main procedure. Objectives: Study on a less invasive surgical technique in esophagectomy with supported thoracoscopy to provide a new esophageal cancer treatment. Subjects and method: Application on a new technique via thoracoscopy to esophagectomy totally in 6 patients (1 female, 5 males), aged 60 years on average, treated in Digestive Surgery Department of Binh Dan hospital from March 2006 to June 2006. Results: The average surgical time was 260 minutes. There was no event during operation. Postoperative complications included: 1 patient had to stitch abdominal wall after operative 7 days, 3 patients with pneumonia after successful operation, 2 patients with right pneumothorax, having to put siphonage. There was one case of death without related to operative technique. Conclusion: Esophagectomy is major operation that can be conducted via open surgery or laparoscopic surgery. Although small case studies, researchers found that laparoscopic surgery is a feasible technique, can be performed safely if the surgeons having experience in open surgery and good skills on laparoscopic surgery. However, thoracoscopic esophagectomy can only be considered as a surgical method, without an alternative method to traditional open surgery.

80 cases without expanded pylorotomy during esophageal replacement by gastric tube

Aims: Esophageal replacement by gastric tube is present the procedure of choice in surgical treatment of carcinoma of esophagus. We would like to present our experiences in esophageal replacement by gastric tube without pyloroplasty in the Gastrointestinal Surgical Division at Binh Dan Hospital. Results: During 22 years (1979-2000), we performed 80 cases of esophagoplasty by gastric tube without pyloroplasty for 3 females and 77 males. The patient mean age was 61 years old. There were 51 cases of cancer of middle 1/3, 27 cases of cancer of the lower 1/3 and 2 cases of cancer of the cardio with esophageal extension. We had 24 cases of total esophagectomy, 29 cases of blunt esophagestomy and 27 cases of esophageal reconstruction by gastric tube. In 53 cases, gastric tube was in posterior mediastinum and 27 cases in substernal position. There were 15 patients presented postoperative pneumonia, 8 cases of anastomotic leakage in the neck, 4 cases of pneumothorax, 1 case with splenic rupture, 1 case of jejunal perforation, 2 cases of leakage of abdominal esophageal stump. The mean hospital stay was 20 days. No gastric emptying trouble was noted in this study. The functional results were good in patients survived this operation. Conclusion: The vascularization of the stomach was very good. In our experiences, esophageal reconstruction by gastric tube foiling Akiyama technique without pyloroplasty was suitable for all cases of esophageal cancer.