Minimally Invasive Esophagectomy for Adenocarcinomas of the Gastroesophageal Junction and Distal Esophagus: Notes on Technique

Journal of Laparoendoscopic&Advanced Surgical Techniques , Vol. 0, No. 0.
Source: Journal of Laparoendoscopic and Advanced Surgical Techniques - Category: Surgery Authors: Source Type: research

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ConclusionsLaparoscopic transhiatal esophagectomy has an important role in current esophageal cancer treatment and can be performed with curative intent in patients with distal esophageal tumors. In addition to the well-known advantages of laparoscopy, the increased mediastinal visibility and a modern focus on oncologic principles seem to have a positive impact on cancer survival compared to the open transhiatal approach.
Source: Journal of Gastrointestinal Surgery - Category: Surgery Source Type: research
ConclusionsNeoadjuvant radiotherapy with 46  Gy and concomitant chemotherapy with paclitaxel and carboplatin for the treatment of locally advanced esophageal carcinoma is safe and effective. The results of this modified radiotherapy protocol are encouraging and should be considered in future patient treatment and study designs.
Source: Strahlentherapie und Onkologie - Category: Cancer & Oncology Source Type: research
Authors: Lehwald-Tywuschik N, Steinfurth F, Kröpil F, Krieg A, Sarikaya H, Knoefel WT, Krüger M, Benhidjeb T, Beshay M, Schulte Am Esch J Abstract Surgical therapy for adenocarcinoma of the esophagogastric junction II requires distal esophagectomy, in which a transhiatal management of the lower esophagus is critical. The 'dorsal track control' (DTC) maneuver presented here facilitates the atraumatic handling of the distal esophagus, in preparation for a circular-stapled esophagojejunostomy. It is based on a ventral semicircular incision in the distal esophagus, with an intact dorsal wall for traction cont...
Source: Journal of Gastric Cancer - Category: Gastroenterology Tags: J Gastric Cancer Source Type: research
AbstractBackgroundResearch in early esophageal adenocarcinoma focused on prediction of lymph node metastases in order to stratify patients for endoscopic treatment instead of esophagectomy. Although distant metastases were described in rates of up to 13% of patients within a follow-up of 3  years, their prediction has been neglected so far.MethodsIn a secondary analysis, a cohort of 217 patients (53 T1a and 164 T1b) treated by esophagectomy was analyzed for histopathological risk factors. Their ability to predict the combination of lymph node metastases at surgery as well as metachronous locoregional and distant metas...
Source: World Journal of Surgery - Category: Surgery Source Type: research
Whereas the incidence of esophageal adenocarcinoma is increasing in Western countries, squamous cell carcinoma remains the main histological type of esophageal cancer in Japan (88.3%).1 The nationwide Japanese registry shows that both the frequency of nodal metastasis and efficacy index of lymphadenectomy are highest for the upper mediastinal nodal station in patients with upper (42.9%, 17.6; respectively) and middle (37.4%, 15.0; respectively) esophageal cancer.2 Recurrent laryngeal nerve (RLN) palsy is one of the most feared complications in patients with esophageal cancer who undergo esophagectomy plus meticulous upper ...
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Surgeon at Work Source Type: research
Salvage and delayed esophagectomy after chemoradiation (CRT) have been associated with increased morbidity and mortality, but recent series have shown similar outcomes compared to timely esophagectomy. We aim to evaluate outcomes for delayed and salvage esophagectomy for esophageal adenocarcinoma utilizing a large national database.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
The last 3  decades have seen progress in the treatment of esophageal cancer, with a reduction in mortality rates for esophagectomy at high-volume specialty centers. We have seen advances in our understanding of the potential advantages of neoadjuvant and adjuvant therapies and progress in our ability to perf orm minimally invasive esophagectomy.1 There is promise that we will witness success with immunotherapies to further improve the outlook for treating this high-mortality cancer. However, while we make progress after the diagnosis is made, appropriate screening and diagnosing guidelines for endoscopy in patients w...
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Commentary Source Type: research
Abstract Background: Clinical nodal (cN) staging is a key element in treatment decisions in patients with esophageal cancer (EC). The reliability of cN status regarding the effect on response and survival after neoadjuvant chemoradiotherapy (nCRT) with esophagectomy was evaluated in determining the up- and downstaged pathological nodal (pN) status after surgery alone. Material and methods: From a prospective database, we included all 395 EC patients who had surgery with curative intent with or without nCRT between 2000 and 2015. All patients were staged by a standard pretreatment protocol: 16-64 mdCT, 18 F-...
Source: Acta Oncologica - Category: Cancer & Oncology Authors: Tags: Acta Oncol Source Type: research
Conclusions: In a large, propensity-matched cohort, adjuvant chemotherapy was associated with significantly improved survival for patients with node-positive esophageal adenocarcinoma after neoadjuvant therapy and complete resection. This finding supports the use of adjuvant therapy for patients with node-positive adenocarcinoma after neoadjuvant therapy and surgery. PMID: 31372291 [PubMed]
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
ConclusionIn this national analysis, surgery for cT4a esophageal adenocarcinoma was associated with improved outcomes when compared to definitive chemoradiation. Surgery should be considered for medically fit patients with cT4aN0-3M0 esophageal adenocarcinoma.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
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