Endoscopic surgery of the oesophagus

European Journal of Gastroenterology and Hepatology

Volumn 9, Issue 8, 1997, Pages 761-765

  Chan, Angus C W ^a   Chung, S C Sydney ^a  

^a CHINESE UNIVERSITY OF HONG KONG   (Hong Kong)

Author keywords

Endoscopic mucosectomy; Endoscopic surgery; Laparoscopic; Mediastinoscopic; Oesophagus; Thoracoscopic

Indexed keywords

ENDOSCOPIC SURGERY; ESOPHAGUS CANCER; ESOPHAGUS MOTILITY; ESOPHAGUS PERFORATION; ESOPHAGUS SURGERY; HUMAN; LEIOMYOMA; MEDIASTINOSCOPY; PRIORITY JOURNAL; REVIEW;

EID: 0030858881     PISSN: 0954691X     EISSN: None     Source Type: Journal    
DOI: 10.1097/00042737-199708000-00005     Document Type: Review

References (28)

1. Everitt NJ, Glinatsis M, McMahon MJ: Thoracoscopic enucleation of leiomyoma of the oesophagus. Br J Surg 1992, 79:643.
2. Bardini R, Segalin A, Ruol A, et al.: Videothoracoscopic enucleation of esophageal leiomyoma. Ann Thorac Surg 1992, 54:576-577.
3. Hurley JP, McCarthy J, Wood AE: Video-assisted thoracic surgery for enucleation of oesophageal leiomyoma. Minim Invasive Ther 1993, 2:257-259. Five patients were operated on for symptomatic thoracic oesophageal leiomyoma via right |1,2] and left [3] thoracoscopic approaches for upper and distal lesions, respectively. All leiomyomas were enucleated completely with the help of intraoperative endoscopy.
4. Nathanson LK, Gotley D, Smithers M, et al.: Videothoracoscopic primary repair of early distal oesophageal perforation. Aust N Z J Surg 1993, 63:399-403. Two early distal oesophageal perforations after pneumatic dilatation for achalasia were repaired through a left thoracoscopic approach.
5. Shimi S, Nathanson LK, Cuschieri A: Laparoscopic cardiomyotomy for achalasia. J R Coll Surg Edinb 1991, 36:152-154. Laparoscopic Heller's myotomy was performed on a patient with no previous pneumatic dilatation. No antireflux procedure was needed. The authors emphasized the importance of preserving the phrenooesophageal attachments of the lower oesophagus to prevent reflux.
6. Jorgensen JO, Hunt DR: Laparoscopic management of pneumatic dilatation resistant achalasia. Aust N Z J Surg 1993, 63:386-388. Three patients with achalasia resistant to pneumatic dilatation were selected for laparoscopic Heller's myotomy. An antireflux fundoplication were performed as well. The abdominal portion of the oesophagus was fully mobilized during the procedure.
7. Anselmino M, Hinder RA, Filipi CJ, et al.: Laparoscopic Heller cardiomyotomy and thoracoscopic esophageal long myotomy for the treatment of primary esophageal motor disorders. Surg Laparosc Endosc 1993, 3:437-441. The technique was described in two patients and an antireflux procedure was performed including the thoracoscopic myotomy.
8. Pellegrini CA, Wetter LA, Patti M, et al.: Thoracoscopic esophagomyotomy: initial experience with a new approach for the treatment of achalasia. Ann Surg 1992, 216:291-299.
9. Pellegrini CA, Leichter R, Patti M, et al.: Thoracoscopic esophageal myotomy in the treatment of achalasia. Ann Thorac Surg 1993, 56:680-682. Twenty-four patients with achalasia underwent thoracoscopic myotomy [8,9]. Laparoscopic Heller's myotomy was performed in two patients who had initial thoracoscopic myotomy not adequately extended to the stomach. The authors commented thoracoscopic myotomy disrupted the antireflux mechanism much less and so no antireflux procedure was required.
10. Shimi SM, Nathanson LK, Cuschieri A: Thoracoscopic long oesophageal myotomy for nutcracker oesophagus: initial experience of a new surgical approach. Br J Surg 1992, 79:533-536. Long myotomy was performed in three patients with nutcracker oesophagus via left thoracoscopic approach with good results.
11. Cuschieri A, Shimi S, Banting S: Endoscopic oesophagectomy through a right thoracoscopic approach. J R Coll Surg Edinb 1992, 37:7-11.
12. Cuschieri A: Endoscopic subtotal oesophagectomy for cancer using the right thoracoscopic approach. Surg Oncol 1993, 2(suppl. 1):3-11.
13. Cuschieri A: Thoracoscopic subtotal oesophagectomy. Endosc Surg Allied Technol 1994, 2:21-25. Results of a consecutive series of 26 thoracoscopic oesophagectomies were reported over a period of 2 years [11-13]. The pulmonary complication rate was 11.5%. Using the prone position for the thoracoscopic approach reduced chest complications. Exposure of the oesophagus was also enhanced in the prone position. The authors have designed curved instruments especially for oesophageal dissection.
14. Azagra JS, Ceuterick M, Goergen M, et al.: Thoracoscopy in oesophagectomy for oesophageal cancer. Br J Surg 1993, 80:320-321.
15. McAnena OJ, Rogers J, Williams NS: Right thoracoscopically assisted oesophagectomy for cancer. Br J Surg 1994, 81:236-238. These two groups [14,15] have reported a much higher pulmonary complication (> 80%) and recurrent laryngeal nerve damage causing postoperative aspiration. The surgical technique was similar to the others. The difference in the results may be partly due to the selection of patients, the site and stage of tumour.
16. Gossot D, Fourquier P, Celerier M: Thoracoscopic esophagectomy: technique and initial results. Ann Thorac Surg 1993, 56:667-670. Thoracoscopic oesophagectomy was attempted in 15 patients. Three patients required conversion. Two patients required prolonged ventilation due to left atelectasis.
17. Collard IM, Lengele B, Otte JB, Kestens PJ: En bloc and standard esophagectomies by thoracoscopy. Ann Thorac Surg 1993, 56:675-679. Pathological examination of the specimen confirmed that radical resection for oesophageal cancer could be achieved as in open surgery. Respiratory complications were still common in this series.
18. Lloyd DM, Vipond M, Robertson GSM, et al.: Thoracoscopic oesophago-gastrectomy - a new technique for intrathoracic stapling. Endosc Surg Allied Technol 1994, 2:26-31. Intrathoracic stapling oesophago-gastric anastomosis was successful in five patients after thoracoscopic mobilization. The authors described in detail the technical aspect of the stapling process. This approach could avoid damage to the recurrent laryngeal nerve and the neck dissection. This group achieved an excellent result with no complications and no deaths.
19. Chui PT, Mainland P, Chung SCS, et al.: Anaesthesia for three-stage thoracoscopic oesophagectomy: an initial experience. Anaesth Intens Care 1994, 22:593-596. We reported our early experience in the anaesthetic management of five patients undergoing thoracoscopic oesophagectomy. Postoperative pulmonary complications were common despite the avoidance of thoracotomy.
20. Manncke K, Raestrup H, Kanehira E, et al.: Thoracoscopic oesophagectomy with intrathoracal stapled anastomosis. Endosc Surg Allied Technol 1994, 2:37-41.
21. Bessell JR, Maddern GJ, Manncke K, et al.: Combined thoracoscopic and laparoscopic oesophagectomy and oesophagogastric reconstruction. Endosc Surg Allied Technol 1994, 2:32-36. Intrathoracic stapled oesophago-gastric anastomosis was examined on animal models and two slightly different techniques were described [20,21]. Endoscopic mobilization of the stomach was also attempted by Bessell's group.
22. Buess G: Thoracoscopic dissection of the oesophagus. Surg Endosc 1992, 6:150-151.
23. Bumm R, Holscher AH, Feussner H, et al.: Endodissection of the thoracic esophagus. Ann Surg 1993, 218:97-104.
24. Bumm R, Siewert JR: Results of transmediastinal endoscopic oesophageal dissection. Endosc Surg Allied Technol 1994, 2:16-20.
25. Manncke K, Raestrup H, Walter D, et al.: Technique of endoscopic mediastinal dissection of the oesophagus. Endosc Surg Allied Technol 1994, 2:10-15. These two groups [22-25] were the pioneers in the transmediastinal approach of the oesophagus and presented their results in 93 patients. The technique is well described and achieved favourable results in early distal oesophageal tumour.
26. Sadanaga N, Kuwano H, Watanabe M, et al.: Laparoscopy-assisted surgery: a new technique for transhiatal esophageal dissection. Am J Surg 1994, 168:355-357. Transhiatal dissection of the oesophagus was achieved in one patient using the laparoscopic instruments via the hiatus at the laparotomy wound. Strictly speaking, this was not laparoscopic oesophagectomy.
27. Dallemagne B, Weerts JM, Jehaes C, et al.: Case report: subtotal oesophagectomy by thoracoscopy and laparoscopy. Minim Invasive Ther 1992, 1/2:183-185. Thoracoscopic oesophagectomy with laparoscopic stomach mobilization was performed on a patient with squamous cell tumour of oesophagus.
28. Endo M: Endoscopic resection as local treatment of mucosal cancer of the oesophagus. Endoscopy 1993, 25(suppl.):672-674. Mucosal cancers less than 3 cm in size without nodal involvement were suitable for endoscopic resection. Tumour was snared completely. No postoperative complication was encountered and complete cure was achieved in eight patients.