XVI. Annual Meeting of the European Society of Surgery, İstanbul, Türkiye, 22 - 24 Kasım 2012, cilt.44, ss.1-70
Background&Aims: Technical feasibility in thoracoscopy have
made it possible to perform esophagectomy with extensive lymphadenectomy (upper mediastinal, paratracheal, paraesophageal
and subcarinal). Aim of this study was to assess our outcomes of
extensive mediastinal lymphadenectomy in esophageal cancer.
Methods: Thoracoscopy assisted three-field esophagectomy
was performed in 27 patients from January 2008 to February 2012.
Procedure was divided in three stages. Thorocoscopic esophageal
mobilization and mediastinal lymph node dissection was followed
by laparotomy, celiac lymph node dissection and creation of gastric
tube. Finally cervical lymph node dissection and hypopharyngogastrostomy was generated via cervical incision.
Results: Median age was 54.9 (43–64) of 17 (63 %) men and 10
(37 %) women. The average operation time was 214±18.6 min and the
average thorocoscopy time was 88±14 min. The average number of
all retrieved lymph nodes was 36±14.2 and mediastinal lymph nodes
average was 28.2±12.8. No respiratory complication was observed,
hoarseness occurred in three (11 %) patients and two (7 %) patients
have anastomotic stenosis. Mean follow-up time was 28 month and
median survival was 22 month.
Conclusion: Minimal invasive surgery in esophagectomy have
demonstrated feasibility of mediastinal lymph node dissection without increased complications.