Thoracoscopic en bloc total esophagectomy with radical mediastinal lymphadenectomy Takashi Akaishi, MD, Iwao Kaneda, MD, Norio Higuchi, MD, Yoshiki Kuriya,

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Presentation transcript:

Thoracoscopic en bloc total esophagectomy with radical mediastinal lymphadenectomy Takashi Akaishi, MD, Iwao Kaneda, MD, Norio Higuchi, MD, Yoshiki Kuriya, MD, Jun-ichi Kuramoto, MD, Tsuneo Toyoda, MD, Akio Wakabayashi, MD The Journal of Thoracic and Cardiovascular Surgery Volume 112, Issue 6, Pages 1533-1541 (December 1996) DOI: 10.1016/S0022-5223(96)70012-0 Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 1 Trocar sites. Roman numerals indicate ribs. PA, Posterior axillar line; MA, midaxillary line; AA, anterior axillary line; MC, midclavicular line. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1533-1541DOI: (10.1016/S0022-5223(96)70012-0) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 2 Marionette technique. A, Step 1. Putting running suture on mediastinal pleura. B, Step 2. Guiding each end of suture and retracting it under mild tension. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1533-1541DOI: (10.1016/S0022-5223(96)70012-0) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 2 Marionette technique. A, Step 1. Putting running suture on mediastinal pleura. B, Step 2. Guiding each end of suture and retracting it under mild tension. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1533-1541DOI: (10.1016/S0022-5223(96)70012-0) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 3 Distribution of harvested mediastinal lymph nodes and incidence of metastasis. (Adapted from Kakegawa T, Hujita H, Yamana H. Illustrations of surgery for carcinoma in the thoracic esophagus. In: Sato T, Iizuka T, editors. Color atlas of surgical anatomy for esophageal cancer. Tokyo: Springer-Verlag, 1992:91-116. Used with permission.) The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1533-1541DOI: (10.1016/S0022-5223(96)70012-0) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 4 Correlation between wall penetration of tumor (pathologic T factor) and incidence of mediastinal lymph node metastasis. ns, Not significant. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1533-1541DOI: (10.1016/S0022-5223(96)70012-0) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 5 Postoperative changes in spirometric data. FEV1, Forced expiratory volume in 1 second. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1533-1541DOI: (10.1016/S0022-5223(96)70012-0) Copyright © 1996 Mosby, Inc. Terms and Conditions