Present state of the Mini-Invasive Surgery (MIS) in esophageal and gastric cancer

RESUMEN

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ABSTRACT

The purpose of this review is to stress the role of theMini-Invasive Surgery (MIS) in the treatment of theesophagogastric malignant illnesses, supporting ourselveson the most relevant publications of the literatureas well as on our own experience in this subject.In short, although no randomised prospective studyhas proven the MIS advantages in relation to thetraditional surgery in the esophagectomy due tocancer, some authors preferently indicate this approachto selected and informed enough patients,who present the following− High grade dysplasia, preferently choosing fromlaparoscopic transhiatal esophagectomy (LTE).− Carcinoma in situ, preferently choosing the LTEvs thoracoscopy.− Esophageal tumour locally advanced, in resectablepatients with contraindication for a thoracotomyor, in initially non-resectable patients withtumoral reduction after neo-adjuvant chemo-radiotherapy.The arguments given by the authors are the postoperativespectacular improvement in relation to thecomfort and quality of life and, the absence of oncologicalnegative effects in the long-term followup.Concerning gastric cancer, the MIS, as exeresis surgicaltool in the so-called «advanced» gastric forms,is such a definite and oncological approach as thetraditional approach, and superior to this as far asquality of life is concerned.When the MIS is used for treating locally advancedforms of gastric cancer, it is as safe as the laparotomicway and it seems to obtain the same oncologicaloutcomes in the long-term