Open AccessNo obvious advantages for thoracoscopic two‐stage oesophagectomy
Author(s) -
Robertson G. S. M.,
Lloyd D. M.,
Wicks A. C. B.,
Veitch P. S.
Publication year - 1996
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.1800830527
Subject(s) - medicine , atelectasis , surgery , thoracotomy , anastomosis , pneumonia , pleural effusion , thoracoscopy , dissection (medical) , context (archaeology) , esophagectomy , esophageal cancer , lung , cancer , paleontology , biology
Thoracoscopically assisted Ivor‐Lewis oesophagectomy potentially combines the pulmonary advantages of transhiatal oesophageal dissection, with the visibility and control permitted by thoracotomy. This study reviewed 17 patients who underwent this procedure with an intrathoracic anastomosis. Five patients required conversion to thoracotomy, four because of technical difficulties with the anastomosis. After operation 13 patients had radiological evidence of atelectasis, six developed a left pleural effusion and five had clinically significant pneumonia. Three patients developed an anastomotic leak, two of whom died giving an in‐hospital mortality rate of 12 per cent. Median postoperative hospital stay was 12 days. Four patients developed benign anastomotic strictures requiring dilatation. The 1‐ and 2‐year survival rates were 73 per cent (11 of 15 patients) and 63 per cent (five of eight) respectively. The use of minimal access techniques in this context does not appear to reduce the postoperative incidence of either pulmonary or anastomotic complications.