ABSTRACT
BACKGROUND: Esophagectomy has high cardiac and pulmonary complication rates that can reach 43% and 58% respectively. The original Ivor Lewis esophagectomy was a two-stage procedure. We revisited this procedure using a hybrid minimally-invasive approach. METHODS: Thirty-five consecutive patients with esophageal cancer were operated on over an eight-year period. The first stage used laparoscopic mobilization of the stomach, while the second stage used open thoracotomy. Six patients were aborted due to unresectable disease. RESULTS: Twenty-nine patients were studied. The mean operative times for stage-one and stage-two were 108⯱â¯18 and 226⯱â¯63â¯min respectively. All patients were extubated in the operating room. One (3.4%) patients had cardiac complication and one (3.4%) patient had pulmonary complication. CONCLUSION: Metachronous hybrid two-stage esophagectomy was associated with a low rate of cardio-pulmonary complications. It may be considered as an alternative to the one-stage esophagectomy, especially in low-volume centers, to decrease these high-risk cardio-pulmonary complications.
Subject(s)
Esophageal Neoplasms/surgery , Esophagectomy/methods , Minimally Invasive Surgical Procedures/methods , Postoperative Complications/epidemiology , Female , Humans , Ischemic Preconditioning , Length of Stay/statistics & numerical data , Male , Middle Aged , Operative Time , Postoperative Complications/prevention & control , Risk , ThoracotomyABSTRACT
Split notochord syndrome with dorsal enteric fistula is an extremely rare congenital anomaly that may be associated with meningomyelocele or meningocele, and genitourinary anomalies. This case presented with an additional finding of bladder exstrophy, raising the possibility of a relationship between this syndrome and the OEIS complex.
