This retrospective analysis of salvage esophagectomy after definitive chemoradiotherapy in 308 patients identified increased mortality and morbidity associated with squamous histology and radiation dose >55 Gy. Survival at three years was 34%.
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Esophageal Cancer - Surgery
April 13, 2018
Patient Care Michael Mack and Alec Vahanian discuss the state and future of transcatheter mitral valve replacement.
March 13, 2018
Reddy and colleagues evaluated oral, esophageal, and gastric microbial flora in 55 patients who underwent successful esophagectomy for adenocarcinoma, squamous cell carcinoma, or benign disease. The authors did not observe significant patterns between microbiome diversity and tumor stage or histology.
January 23, 2018
Miller and colleagues retrospectively compared anastomotic integrity with pleural amylase levels (PAL), measured daily from postoperative day 3-10 after an Ivor Lewis esophagectomy. Three of 45 patients had an anastomotic leak, each of which coincided with a large increase in their PAL.
January 10, 2018
The authors review their clinical experience with management of postoperative chylothorax among 97 patients. They favor duct ligation over embolization, and recommend intervention in patients with outputs greater than 1,100/day.
Near-Infrared Image-Guided Lymphatic Mapping in Minimally Invasive Oesophagectomy of Distal Oesophageal Cancer
October 20, 2017
Helminen and colleagues employ near-infrared imaging as a novel technique for lymphatic mapping in minimally invasive esophagectomy of distal esophageal cancer. Indocyanine green dye was injected endoscopically and used to identify nodal stations outside of the en bloc resection area.
September 27, 2017
This article describes an entirely hand-sewn VATS intrathoracic esophagogastric anastomosis technique in a 64-year-old woman with a T2N0M0 adenocarcinoma of the lower third of the esophagus.
Minimally Invasive Esophagectomy Provides Equivalent Survival to Open Esophagectomy: An Analysis of the National Cancer Database
August 22, 2017
The authors compare outcomes of open versus minimally invasive esophagectomy (OE, MIE) from the National Cancer Databased (NCDB) 2010-2012 and use propensity scoring to match patients (977 pairs). Short term outcomes were equivalent for LOS and mortality, and median survival was similar. Nodal removal was higher for MIE (16.3 vs 14.5).
April 17, 2017
In a retrospective review of patients undergoing esophagectomy at two high volume centers, the incidence of hiatal hernia was 5% - 10%. The incidence did not differ between open and MIE approaches. Two-thirds of the hernias were discovered incidentally, although half of those patients were symptomatic.
November 23, 2016
This retrospective single institution study evaluated the relationship between radiation dose to the gastric fundus and the incidence of esophageal anastomotic leak after esophagectomy for cancer. The leak rate was 26%. Pts with a leak had a significantly higher RT dose to the gastric fundus. Using a cut point of 31.4 Gy, leak rates were 43% vs 15