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. 2024 Feb 1;34(1):108-112.
doi: 10.1097/SLE.0000000000001250.

A Novel Method for Thoracoscopic Overlap Esophagogastric Reconstruction With Pleural Closure following Minimally Invasive Ivor-Lewis Esophagectomy for Esophagogastric Junction Cancer

Akihiko Sano  1 , Makoto Sohda  1 , Nobuhiro Hosoi  1 , Kohei Tateno  1 , Takayoshi Watanabe  1 , Nobuhiro Nakazawa  1 , Ikuma Shioi  1 , Yuta Shibasaki  1 , Takuhisa Okada  1 , Katsuya Osone  1 , Takuya Shiraishi  1 , Makoto Sakai  1 , Hiroomi Ogawa  1 , Hiroshi Okabe  2 , Ken Shirabe  1 , Hiroshi Saeki  1
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A Novel Method for Thoracoscopic Overlap Esophagogastric Reconstruction With Pleural Closure following Minimally Invasive Ivor-Lewis Esophagectomy for Esophagogastric Junction Cancer

Akihiko Sano et al. Surg Laparosc Endosc Percutan Tech. .

Abstract

Background: Intrathoracic esophagogastric anastomosis following minimally invasive Ivor-Lewis esophagectomy is a technically demanding surgical technique that can result in serious intrathoracic infections when anastomotic leakage occurs. Herein, we report a novel side-overlap esophagogastric anastomosis with pleural closure for esophagogastric junction cancer.

Methods: The 3 key points of our novel technique were the following: (1) overlap esophagogastric anastomosis and closure of the entry hole were all performed using a linear stapler; (2) the pleura was closed to separate the anastomotic site from the thoracic cavity; and (3) the mediastinal drain was inserted transhiatally from the abdominal cavity.

Results: This modified anastomosis procedure was performed on 8 consecutive patients at our institution. The median overall/thoracoscopic operating time and estimated blood loss were 652.5/241.5 min and 89 mL, respectively. No mortality or serious postoperative complications occurred, and the median postoperative hospital stay was 22 days (range, 17 to 37 d).

Conclusion: This novel thoracoscopic overlap esophagogastric reconstruction procedure with pleural closure is safe and feasible.

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Conflict of interest statement

The author declares no conflicts of interest.

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References

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