+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Application of a modified McKeown procedure (thoracoscopic esophageal mobilization three-incision esophagectomy) in esophageal cancer surgery: initial experience with 30 cases

Application of a modified McKeown procedure (thoracoscopic esophageal mobilization three-incision esophagectomy) in esophageal cancer surgery: initial experience with 30 cases

Diseases of the Esophagus 22(8): 687-693

Early efforts with minimally invasive esophagectomy (MIE) were hybrid approaches. No conclusive benefit was seen with this approach compared with the standard open procedure. Total MIE has demonstrated its advantages in single institution series. The drawbacks of total MIE include the steep learning curve and the high cost of the disposable instrumentation. We sought to determine the feasibility of modifying the surgical technique involved in the hybrid approach in an effort to decrease the cost of the surgery without compromising the outcome. From December 2007 to September 2008, the modified McKeown procedure (thoracoscopic esophageal mobilization three-incision esophagectomy) was performed in 30 cases. The median operative time was 225 minutes (range, 195 -290 minutes) and the median average time of VATS was 70 minutes (range, 50 -130 minutes). Median lymph node retrieval was 25.6 +/- 4.8 nodes (15.1 +/- 3.4 intrathoracic) per patient. The median postoperative hospital stay was 17.1 +/- 6.3 days. There was no in-hospital (30 days) mortality. Postoperative complications occurred in 9 patients (30%), including 2 (6.7%) pneumonia, 1 (3.3%) chylothorax, 1 (3.3%) delayed gastric emptying, 1 (3.3%) vocal cord palsy, 2 (6.7%) neck anastomotic leaks, and 2 (6.7%) arrhythmias. This procedure is technically feasible and safe with lower mortality and mobility. The short-term surgical outcomes are comparable with most of the total MIE reports. Performing the gastric mobilization and spontaneous neck anastomosis first greatly facilitate and simplifies the VATS maneuver.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 051607391

Download citation: RISBibTeXText

PMID: 19392854

DOI: 10.1111/j.1442-2050.2009.00963.x

Related references

Minimally invasive esophagectomy: thoracoscopic esophageal mobilization for esophageal cancer with the patient in prone position. Surgical Endoscopy 26(4): 1102-1107, 2012

Combined laparoscopic and thoracoscopic Ivor Lewis esophagectomy for esophageal cancer: initial experience from China. Chinese Medical Journal 125(8): 1376-1380, 2012

Totally minimally invasive Ivor-Lewis esophagectomy with single-utility incision video-assisted thoracoscopic surgery for treatment of mid-lower esophageal cancer. Diseases of the Esophagus 29(2): 139-145, 2016

Modified McKeown minimally invasive esophagectomy for esophageal cancer: a 5-year retrospective study of 142 patients in a single institution. Plos one 8(12): E82428, 2013

Outcomes of thoracoscopic esophagectomy in prone position with laparoscopic gastric mobilization for esophageal cancer. Langenbeck's Archives of Surgery 401(5): 699-705, 2016

Comparison of thoracolaparoscopic esophagectomy with cervical anastomosis with McKeown esophagectomy for middle esophageal cancer. World Journal of Surgical Oncology 13: 310, 2015

Comparison of short-term outcomes between minimally invasive McKeown esophagectomy and Ivor-Lewis esophagectomy for esophageal cancer. Zhong Nan Da Xue Xue Bao. Yi Xue Ban 42(5): 546-552, 2017

Thoracoscopic esophagectomy for esophageal cancer. Personal experience. Minerva Chirurgica 57(2): 111-115, 2002

Thoracoscopic esophagectomy and hand-assisted laparoscopic gastric mobilization for esophageal cancer with situs inversus totalis. Journal of Gastrointestinal Surgery 16(6): 1235-1239, 2012

Video-assisted thoracoscopic esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in thoracic cavity: analysis of 60 cases. Zhonghua Wai Ke Za Zhi 51(4): 354-357, 2013

Low invasiveness of thoracoscopic esophagectomy in the prone position for esophageal cancer: a propensity score-matched comparison of operative approaches between thoracoscopic and open esophagectomy. Surgical Endoscopy 32(4): 1945-1953, 2018

The management of esophageal cancer with situs inversus totalis by simultaneous hand-assisted laparoscopic gastric mobilization and thoracoscopic esophagectomy. Journal of Laparoendoscopic and Advanced Surgical Techniques. Part a 14(6): 384-389, 2004

Acute esophageal necrosis with esophagus perforation treated by thoracoscopic subtotal esophagectomy and reconstructive surgery on a secondary esophageal stricture: a case report. Surgical Case Reports 5(1): 73, 2019

Three cases of esophageal cancer with aberrant right subclavian artery treated by thoracoscopic esophagectomy. Esophagus 10(3): 165-169, 2013

Prone thoracoscopic esophageal mobilization for minimally invasive esophagectomy. Surgical Endoscopy 21(9): 1667-1670, 2007