Background and aims: The operative mortality and morbidity associated with esophageal surgery has been decreasing with advances in surgical techniques and equipment, however, postoperative complication remains a major cause of a potentially fatal outcome. We herein describe a new technique for esophagectomy by total laparoscopic gastric mobilization technique as a minimally invasive surgery.
Patients and methods: Between April 2003 and August 2007, 36 patients who were suffering from esophageal cancer were surgically resected at Kochi Medical School. Operation-related parameters, mortality, postoperative complication, intubation time, and length of surgical intensive care unit in patients with total laparoscopic gastric mobilization for esophagectomy (the TLGM group, n = 16) were evaluated, compared to patients with ordinary thoraco-abdominal esophagectomy (the OPEN group, n = 20).
Results: There was no mortality in the TLGM group and one hospital death in the OPEN group. Operation time of the OPEN group (506 +/- 64 min) was significant shorter than that of the TLGM group (558 +/- 67 min). The estimated intraoperative blood loss volume in patients of the TLGM group (496 +/- 259 mL) was much smaller than those of the OPEN group (1,067 +/- 566 mL). The intubation time and the intensive care unit stay in the TLGM group were much shorter than that in the OPEN group.
Conclusions: Esophagectomy with regional lymphadenectomy combined with total laparoscopic gastric mobilization is a safe and beneficial opportunity for patients who underwent surgical procedure for esophageal cancer.