Cirugía laparoscópica en el cáncer de esófago / Laparoscopic surgery in cancer of the esophagus

Introducción. Desde hace un año hemos sustituido la laparotomía por la laparoscopia para realizar la fase abdominal de la cirugía del cáncer de esófago. Presentamos nuestra experiencia con la introducción de la cirugía videoasistida en el tratamiento quirúrgico del cáncer de esófago. Pacientes y método. Aportamos nuestra experiencia con 9 pacientes diagnosticados de cáncer de esófago. En 7 la laparoscopia estuvo precedida de una toracotomía derecha y una disección esofágica. Mediante una cervicotomía lateral izquierda se extrajo la pieza y se elaboró la anastomosis. En otros 2 pacientes, la laparoscopia fue previa y la técnica de Ibor Lewis se completó mediante toracotomía derecha. Resultados. Los resultados son aún poco valorables, dado el reducido número de pacientes operados. La morbilidad se sitúa en el 38,3%. La duración media de la intervención efectuada por laparoscopia se fija en 4 h y 50 min. Constatamos unos valores reducidos en requerimientos de sangre perioperatoria, complicaciones postoperatorias, analgesia y estancia hospitalaria. Conclusiones. La esofagectomía mínimamente invasiva puede ser realizada de una manera tan segura como la convencional y tiene grandes ventajas perioperatorias. La introducción de la laparoscopia representa para nosotros un primer paso para llegar a un procedimiento videoasistido en todas sus fases (AU)

Introduction. For the last year we have substituted laparotomy with laparoscopy for the abdominal stage of esophageal cancer surgery. We report our experience of the introduction of video-assisted surgery in the treatment of esophageal cancer. Patients and method. We report our experience of nine patients diagnosed with esophageal cancer. In seven patients laparoscopy was preceded by right thoracotomy and esophageal dissection. Then, a left anterolateral cervicotomy was performed to remove the specimen and to construct the esophagogastroanastomosis. In two patients the laparoscopic technique was performed first and the Ivor Lewis procedure was completed by right thoracotomy. Results. Due to the reduced number of operated patients, the results are of little significance. Morbidity was 38.3%. The mean duration of the surgical procedure in laparoscopic patients was 4h 50min. However, perioperative blood loss, postoperative complications, analgesic requirements and mean length of hospital stay were reduced. Conclusions. Video-assisted esophagectomy can be performed as safely as conventional esophagectomy and has considerable perioperative advantages. The introduction of the laparoscopic procedure is the first step in using video-assisted surgery at all stages of esophageal cancer surgery (AU)

[Laparoscopic surgery in cancer of the esophagus]. / Cirugía laparoscópica en el cáncer de esófago.

INTRODUCTION: For the last year we have substituted laparotomy with laparoscopy for the abdominal stage of esophageal cancer surgery. We report our experience of the introduction of video-assisted surgery in the treatment of esophageal cancer. PATIENTS AND METHOD: We report our experience of nine patients diagnosed with esophageal cancer. In seven patients laparoscopy was preceded by right thoracotomy and esophageal dissection. Then, a left anterolateral cervicotomy was performed to remove the specimen and to construct the esophagogastroanastomosis. In two patients the laparoscopic technique was performed first and the Ivor Lewis procedure was completed by right thoracotomy. RESULTS: Due to the reduced number of operated patients, the results are of little significance. Morbidity was 38.3%. The mean duration of the surgical procedure in laparoscopic patients was 4 h 50 min. However, perioperative blood loss, postoperative complications, analgesic requirements and mean length of hospital stay were reduced. CONCLUSIONS: Video-assisted esophagectomy can be performed as safely as conventional esophagectomy and has considerable perioperative advantages. The introduction of the laparoscopic procedure is the first step in using video-assisted surgery at all stages of esophageal cancer surgery.