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首页> 外文期刊>Surgical Endoscopy >Totally laparoscopic transhiatal esophago-gastrectomy without thoracic or cervical access. The least invasive surgery for adenocarcinoma of the cardia?
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Totally laparoscopic transhiatal esophago-gastrectomy without thoracic or cervical access. The least invasive surgery for adenocarcinoma of the cardia?

机译：完全腹腔镜经食管胃食管胃切除术，无胸腔或颈椎通道。 the门腺癌的微创手术？

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BACKGROUND: The recent progress of minimally invasive surgery has allowed esophagectomy to be performed by both combined laparoscopic/thoracoscopic and totally laparoscopic transhiatal approaches. All these techniques imply a thoracic and/or cervical access for the creation of the esophagogastric anastomosis. METHODS: Five surgical ports are introduced in the abdomen. The stomach is mobilized, divided, and tubulized, preserving the right arteries. The lymphadenectomy of the celiac trunk and the hepatic pedicle is achieved. The dissection and resection of distal esophagus and a two-fields mediastinal lymphadenectomy are performed by means of harmonic scalpel. The realization of the intrathoracic esophago-gastrostomy is accomplished by means of a circular stapler. RESULTS: Three patients underwent the procedure. Mean operating time and blood loss were 347 min and 360 cc. There were no intraoperative or postoperative complications. Mean postoperative stay was 9 days. CONCLUSION: In selected cases, it is possible to perform a distal esophagectomy entirely by laparoscopy, without the need for any thoracic or cervical access.
机译：背景：微创外科手术的最新进展已允许通过组合腹腔镜/胸腔镜和全腹腔镜经皮途径进行食管切除术。所有这些技术都意味着通过胸腔和/或颈椎通道来产生食管胃吻合。方法：在腹部引入五个手术端口。胃动员，分开并进行小管切开，保留正确的动脉。实现了腹腔干和肝蒂的淋巴结清扫术。食管远端的解剖和切除以及纵隔淋巴结清扫术分为两场，均采用谐波解剖刀进行。胸腔内食管胃造口术的实现是通过圆形缝合器实现的。结果：3例患者接受了该手术。平均手术时间和失血量为347分钟和360 cc。没有术中或术后并发症。术后平均住院时间为9天。结论：在某些情况下，可以完全通过腹腔镜进行食管远端切除术，而无需任何胸腔或颈椎入路。

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