Skip to main content

Advertisement

SpringerLink
Log in

Mediastinoscope-assisted transhiatal esophagectomy for esophageal cancer

  • Original article
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Background: Transthoracic esophagectomy (TTE) is a radical strategy for treatment of esophageal cancer, and the morbidity and mortality are high. Transhiatal esophagectomy (THE) is advantageous because it avoids thoracotomy and has a shorter surgical time, but risk of intraoperative morbidity stresses the surgeon and lymph node sampling is not possible. Methods: Mediastinoscope-assited transhiatal esophagectomy (MATHE) was performed in 42 patients with esophageal cancer. Patients with superficial esophageal cancer and medical risk were included. Feasibility and efficacy of this procedure are discussed by examining short- and long-term morbidity, mortality, and survival. Results: With the mediastinoscope, esophagectomy was performed safely under direct vision. There was only a small amount of bleeding, and surgical time was short. Little morbidity and no deaths were recorded. Conclusion: MATHE is a safe and minimally invasive technique that allows direct visualization of mediastinal structures Lymph node sampling was feasible because of clear visualization of the mediastinum.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. H Akiyama M Tsurumaru H Udagawa Y Kijiyama (1994) ArticleTitleRadical lymph node dissection for cancer of the thoracic esophagus. Ann Surg 220 364–373 Occurrence Handle1:STN:280:ByuA2sbos10%3D Occurrence Handle8092902

    CAS  PubMed  Google Scholar 

  2. D Alderson SP Courtney RH Kennedy (1994) ArticleTitleRadical transhiatal oesophagectomy under direct vision. Br J Surg 81 404–407 Occurrence Handle1:STN:280:ByuB38fis1U%3D Occurrence Handle8173913

    CAS  PubMed  Google Scholar 

  3. NK Altorki L Girardi DB Skinner (1997) ArticleTitleEn bloc esophagectomy improves survival for stage III esophageal cancer. J Thorac Cardiovasc Surg 114 948–956 Occurrence Handle1:STN:280:DyaK1c%2Fps1ejsQ%3D%3D Occurrence Handle9434690

    CAS  PubMed  Google Scholar 

  4. JS Azagra M Ceuterick M Georgen D Jacobs E Gilbart G Zaouk E Carlier P Lejeune JL Alle M Mathys (1993) ArticleTitleThoracoscopy in oesophagectomy for esophageal cancer. Br J Surg 80 320–321 Occurrence Handle1:STN:280:ByyB3s%2FjvVw%3D Occurrence Handle8472139

    CAS  PubMed  Google Scholar 

  5. MJ Boyle D Franceschi AS Livingstone (1999) ArticleTitleTranshiatal versus transthoracic esophagectomy: complication and survival rates. Am Surg 65 1137–1142 Occurrence Handle1:STN:280:DC%2BD3c%2Fmt1WqtQ%3D%3D Occurrence Handle10597061

    CAS  PubMed  Google Scholar 

  6. G Buess J Kaiser K Manncke DH Walter JR Bessell HD Becker (1997) ArticleTitleEndoscopic microsurgical dissection of the esophagus (EMDE). Intern Surg 82 109–112 Occurrence Handle1:STN:280:ByiH2s3oslA%3D

    CAS  Google Scholar 

  7. R Bumm AH Holscher H Feussner M Tachibana H Bartrels JR Siewert (1993) ArticleTitleEndodissection of the thoracic esophagus. Technique and clinical results in transhiatal esophagectomy. Ann Surg 218 97–104 Occurrence Handle1:STN:280:ByyA3Mbjt1M%3D Occurrence Handle8328835

    CAS  PubMed  Google Scholar 

  8. R Bumm H Feussner H Bartels H Stein HJ Dittler H Hofler JR Siewert (1997) ArticleTitleRadical transhiatal esophagectomy with two-field lymphadenectomy and endodissection for distal esophageal adenocarcinoma. World J Surg 21 822–831 Occurrence Handle1:STN:280:ByiH28flvVI%3D Occurrence Handle9327673

    CAS  PubMed  Google Scholar 

  9. J Collard B Lengele J Otte P Kestens (1993) ArticleTitleEn bloc and standard esophagectomies by thoracoscopy. Ann Thorac Surg 56 675–679 Occurrence Handle1:STN:280:ByyA1MzjtFM%3D Occurrence Handle8379769

    CAS  PubMed  Google Scholar 

  10. A Cuschieri S Shimi S Banting (1992) ArticleTitleEndoscopic oesophagectomy through a right thoracoscopic approach. J R Coll Surg Edinb 37 7–11 Occurrence Handle1:STN:280:By2B2czkt1U%3D Occurrence Handle1573620

    CAS  PubMed  Google Scholar 

  11. AL DePaula K Hashiba EAB Ferreira RA Paula E Grecco (1995) ArticleTitleLaparoscopic transhiatal esophagectomy with esophagogastrostroplasty. Surg Laparosc Endosc 5 1–5 Occurrence Handle1:STN:280:ByqB2MzkvVA%3D Occurrence Handle7735533

    CAS  PubMed  Google Scholar 

  12. RJ Finley M Grace JH Duff (1985) ArticleTitleEsophagogastrectomy without thoracotomy for carcinoma of the cardia and lower part of the esophagus. Surg Gynecol Obstet 160 49–56 Occurrence Handle1:STN:280:BiqD28njtVE%3D Occurrence Handle2578073

    CAS  PubMed  Google Scholar 

  13. PP Goodney AE Suwers TA Stukel FL Luca DE Wemberg JP Birkmeyer (2002) ArticleTitleIs surgery getting safer? National trends is operative mortality. J Am Coll Surg 195 219–227 Occurrence Handle10.1016/S1072-7515(02)01228-0 Occurrence Handle12168969

    Article  PubMed  Google Scholar 

  14. d Gossot P Cattan S Fritsch B Halimi E Sarfati M Celerier (1995) ArticleTitleCan the morbidity of esophagectomy be reduced by the thoracoscopic approach? Surg Endosc 9 1113–1115 Occurrence Handle1:STN:280:BymC3MfhtVA%3D Occurrence Handle8553214

    CAS  PubMed  Google Scholar 

  15. DC Gotley J Beard MJ Cooper DC Britton RCN Williamson (1990) ArticleTitleAbdominocervical (transhiatal) esophagectomy in the management of esophageal carcinoma. Br J Surg 77 815–819 Occurrence Handle1:STN:280:By%2BA2crhvFU%3D Occurrence Handle1696513

    CAS  PubMed  Google Scholar 

  16. Y Ikeda M Niimi S Kan H Takami S kodaira (2002) ArticleTitleThoracoscopic esophagectomy combined with mediastinoscopy via the neck. Ann Thorac Surg 73 1329–1331

    Google Scholar 

  17. KW Jauch EA Bacha H Denecke M Anthuber FW Schildberg (1992) ArticleTitleEsophageal carcinoma: prognostic features and comparison between blunt transhiatal dissection and transthoracic resection. Eur J Surg Oncol 18 553–562 Occurrence Handle1:STN:280:ByyC383hvFQ%3D Occurrence Handle1478287

    CAS  PubMed  Google Scholar 

  18. H Kato Y Tachimori H Watanebe H Yamaguchi T Ishilkawa M Itabashi (1990) ArticleTitleSuperficial esophageal carcinoma: surgical treatment and the results. Cancer 66 2319–2323 Occurrence Handle2245387

    PubMed  Google Scholar 

  19. S Law M Fok KM Chu J Wong (1997) ArticleTitleThoracoscopic esophagectomy for esophageal cancer. Surgery 122 8–14 Occurrence Handle1:STN:280:ByiA28bkt1Q%3D Occurrence Handle9225908

    CAS  PubMed  Google Scholar 

  20. JD Luketich P Schauer R Landreneau N Nguyen K Urso P Ferson R Keenan R Kim (1997) ArticleTitleMinimally invasive surgical staging is superior to endoscopic ultrasound in detecting lymph node metastases in esophageal cancer. J Thorac Cardiovasc Surg 114 817–823 Occurrence Handle1:STN:280:DyaK1c%2FktlantQ%3D%3D Occurrence Handle9375612

    CAS  PubMed  Google Scholar 

  21. DJ Mathisen HC Grillo WW Earle CM Ashley AD Hilgenberg (1988) ArticleTitleTransthoracic esophagectomy: a safe approach to carcinoma of the esophagus. Ann Thorac Surg 45 137–143 Occurrence Handle1:STN:280:BieC3szgvVU%3D Occurrence Handle3277551

    CAS  PubMed  Google Scholar 

  22. JM Muller H Erasmi M Stelzner U Zieren H Pichlmaier (1990) ArticleTitleSurgical therapy of oesophageal carcinoma. Br J Surg 77 845–857 Occurrence Handle2203505

    PubMed  Google Scholar 

  23. H Nagawa O Kobori T Muto (1994) ArticleTitlePrediction of pulmonary complications after transthoracic oesophagectomy. Br J Surg 81 860–862 Occurrence Handle1:STN:280:ByuA3Mbos1I%3D Occurrence Handle8044603

    CAS  PubMed  Google Scholar 

  24. MB Orringer JS Orringer (1983) ArticleTitleEsophagectomy without thoracotomy: a dangerous operation? J Thorac Cardiovasc Surg 85 72–76 Occurrence Handle1:STN:280:BiyD1cjisl0%3D Occurrence Handle6848889

    CAS  PubMed  Google Scholar 

  25. MB Orringer B Marshall MD Iannettoni (1999) ArticleTitleTranshiatal esophagectomy: Clinical experience and refinements. Ann Surg 230 392–403 Occurrence Handle10.1097/00000658-199909000-00012 Occurrence Handle1:STN:280:DyaK1MvitFahuw%3D%3D Occurrence Handle10493486

    Article  CAS  PubMed  Google Scholar 

  26. GSM Robertson DM Lloyd ACB Wicks PS Veitch (1996) ArticleTitleNo obvious advantages for thoracoscopic two-stage oesophagectomy. Br J Surg 83 675–678

    Google Scholar 

  27. N Sadanaga H Kuwano M Watanabe M Ikebe M Mori S Maekawa M Hashizume S Kitano K Sugimachi (1994) ArticleTitleLaparoscopy-assisted surgery: a new technique for transhiatal esophagectomy. Am J Surg 168 355–357 Occurrence Handle1:STN:280:ByqD3s%2FhvVA%3D Occurrence Handle7943595

    CAS  PubMed  Google Scholar 

  28. A Segalin L Bonavina R Rosati S Bettazza (1994) ArticleTitleParietal seeding of esophageal cancer after thoracoscopic resection. Dis Esophagus 7 645–645

    Google Scholar 

  29. LL Swanstrom P Hansen (1997) ArticleTitleLaparoscopic total esophagectomy. Arch Surg 132 943–948 Occurrence Handle1:STN:280:ByiH2cjhsFA%3D Occurrence Handle9301605

    CAS  PubMed  Google Scholar 

  30. A Tangoku H Hayashi S Kanamura S Yoshino T Abe Y Yoshimoto T Morioka M Oka (2000) ArticleTitleLymph node metastases identified with mediastinoscopy in patient with superficial carcinoma of the esophagus. Surg Endosc 14 595 Occurrence Handle1:STN:280:DC%2BD38%2Fgsl2qtA%3D%3D

    CAS  Google Scholar 

  31. JJ Terz JD Beatty WA Kokal LD Wagman (1987) ArticleTitleTranshiatal esophagectomy. Am J Surg 154 42–48 Occurrence Handle1:STN:280:BiiB28fjtlA%3D Occurrence Handle2440331

    CAS  PubMed  Google Scholar 

  32. HW Tilanus WC Hop BL Langenhorst JJ van Lanschot (1993) ArticleTitleEsophagectomy with or without thoracotomy. Is there any difference? J Thorac Cardiovasc Surg 105 898–903 Occurrence Handle1:STN:280:ByyB2MvgslA%3D Occurrence Handle8487568

    CAS  PubMed  Google Scholar 

  33. N Vennissac M Alifano BS Karimdjee F Guillot O Rabary J Mouroux (2000) ArticleTitleVideo-mediastinoscopy in management of patients with lung cancer: A preliminary study. Surg Laparosc Endosc 10 71–75 Occurrence Handle10.1097/00019509-200004000-00005

    Article  Google Scholar 

  34. J Wong (1987) ArticleTitleEsophageal resection for cancer: the rationale of current practice. Am J Surg 153 18–24 Occurrence Handle1:STN:280:BiiD1MjntlU%3D Occurrence Handle3799889

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery II, Yamaguchi University School of Medicine, 1-1-1 Minami Kogushi, Ube, Yamaguchi 755-8505, Japan

    A. Tangoku, S. Yoshino, T. Abe, H. Hayashi, T. Satou, T. Ueno & M. Oka

Authors
  1. A. Tangoku
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Yoshino
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. Abe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. Hayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T. Satou
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. T. Ueno
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Oka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Tangoku.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tangoku, A., Yoshino, S., Abe, T. et al. Mediastinoscope-assisted transhiatal esophagectomy for esophageal cancer . Surg Endosc 18, 383–389 (2004). https://doi.org/10.1007/s00464-003-8181-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-003-8181-2

Keywords

Search

Navigation