Esofagectomía mínimamente invasiva: muchos procedimientos, muchos maestros / Minimally invasive esophagectomy, many procedures, many masters

La esofagectomía abierta o mínimamente invasiva, es un procedimiento técnicamente difícil, que requiere experiencia y habilidad por parte del cirujano, asociado a un cuidado pre- y postoperatorio adecuado. Se ha incrementado su uso y ha ganado aceptación dadas sus amplias ventajas, factibilidad y resultados oncológicos tempranos comparables. Al igual que con otros procedimientos, esta técnica tiene múltiples variaciones que van desde la mezcla de abordajes abiertos y vídeoasistidos, hasta aquellos completamente laparoscópicos, hecho que genera mayor comodidad para los cirujanos al momento de elegir un abordaje, de acuerdo con sus fortalezas y habilidades. El objetivo de este artículo es mostrar algunas de las técnicas utilizadas alrededor del mundo, descritas por los cirujanos que las implementan, así como sus claves y secretos

Conventional open or minimally invasive esophagectomy is a complex procedure demanding expertise and advanced technical skills associated with proper perioperative care. Minimally invasive esophagectomy has gained wide acceptance due to being less invasive, its feasibility and similar early oncological outcomes. Surgical technique may range from a hybrid to a completely minimally invasive procedure. This myriad of techniques allow surgeons to choose the most appropriate technique according to his/her reality. This review aims to show the variety of procedures performed at different centers around the world, describing personal preferences on how to perform an esophagectomy and tips and tricks in order to maximize results

Gene Expression Profiling Identified High-mobility Group AT-hook 2 (HMGA2) as Being Frequently Upregulated in Esophageal Squamous Cell Carcinoma.

Background: Esophageal cancer is one of the most deadly malignancies worldwide and esophageal squamous cell carcinoma (ESCC) is the most frequent type. Methods: We identified up-regulated genes from gene expression profiles of HKESC-4 cell line, its parental tumor tissues, non-tumoral esophageal epithelia and lymph nodes with metastatic carcinoma using Human Genome U133 Plus 2.0 microarray. Results: Four genes [High-mobility group AT-hook 2 (HMGA2), paternally expressed 10 (PEG10), SH3 and multiple ankyrin repeat domains 2 (SHANK2) and WNT1 inducible signaling pathway protein 3 (WISP3)] were selected for further validation with real-time quantitative polymerase chain reaction (qPCR) in a panel of ESCC cell lines and clinical specimens. HMGA2 was found to be overexpressed in the panel of ESCC cell lines tested. By using immunohistochemistry, HMGA2 was found to be up-regulated in 70% of ESCC tissues (21 out of 30 cases). Conclusion: This study demonstrates successful use of gene microarray to identify and reveal HMGA2 as a novel and consistently overexpressed gene in ESCC cell lines and clinical samples.