Total laparoscopic gastric mobilization for esophagectomy

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. 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). 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. 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.