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Nicolas Venissac
Jerome Mouroux
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J Thorac Cardiovasc Surg 2007;133:267-268
© 2007 The American Association for Thoracic Surgery

Brief Communication

Video-assisted mediastinoscopy improved radical resection for cancer in transhiatal esophagectomy

Daniel Pop, MD*, Nicolas Venissac, MD, Jerome Mouroux, MD

Thoracic Surgery Department, Pasteur Hospital, Nice, France.

Received for publication June 24, 2006; revisions received August 10, 2006; accepted for publication August 25, 2006.

* Address for reprints: Daniel Pop, MD, Thoracic Surgery Department, Pasteur Hospital—Building H1, 30 Avenue de la Voie Romaine, 06002 Nice, France. (Email: danielpopch@yahoo.com).

The first 20% of the full text of this article appears below.

Transhiatal esophagectomy (THE), popularized by Orringer and Sloan,1Go was proposed to decrease postoperative morbidity and mortality. The major inconvenience is the mediastinal lymphadenectomy that guarantees radical oncologic surgery. Recently, Bumm and associates2Go used an endodissector that eliminated the "blind" mediastinal dissection. Furthermore, the advent of video-assisted technology provided increasing visualization and allowed bimanual maneuvers.3,4Go This is our preliminary report using video-assisted mediastinoscopy (VAM) during THE, including technical details.

Patients and Techniques

Between October 1, 2001 and January 31, 2003 (a 15-month period), we operated on our first 5 patients. The usual pretherapeutic staging and preoperative assessment were done. One patient had neoadjuvant chemoradiotherapy. All 5 patients’ characteristics are noted in Table 1.


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  		TABLE 1. Patients’ characteristics
 
The surgical procedures were done by the same team (surgeon with two assistants). The patients were supine with one roll beneath the scapulae (for maximal cervical extension). The abdominal and cervical phases were done by the standard technique.1Go Care must be taken to avoid arrhythmia . . . [Full Text of this Article]






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