ESOFAGECTOMÍA SUBTOTAL POR ABORDAJE MINI-INVASIVO: RESULTADOS DE UNA EXPERIENCIA INICIAL

Abstract

Background: multiple techniques of esophagectomy are mini-invasive (MIE). Its great heterogeneity makes the meta-analyses do not give conclusive results and series with standardized techniques may be required. There are few published experiences of esophagectomies subtotals with anastomosis performed entirely by the via mini-invasive intrathoracics. There are no publications of MIE in our country.

Objective: To evaluate the initial results of a consecutive series of MIE with intrathoracic anastomosis.

Setting: Hospital Británico de Buenos Aires.

Design: retrospective observational study.

Population: 34 esophagectomies-operated patients completely mini-invasive from 2009 to 2011, with more than 6 months of follow-up.

Method: the hybrid cases (combined approaches mini-invasive and conventional) were excluded. An initial series of EMI with the subtotals intrathoracic anastomosis by totally laparoscopic and thoracoscopic approach was evaluated. Results: Of the 34 EMI, 26 were with intrathoracic anastomosis. There were no conversions. The average num-

ber of nodes resected was 26.1. Total morbidity was 38.2, of which higher subtotals morbidity was the 19.2. There was a (2.9) mortality due to bleeding post endoscopic stent placement. The 85 patients presented survival free of disease with follow-up of 21 months. There were no local recurrences or implants in trocar site.

Conclusions: The EMI with intrathoracic anastomosis is a safe technique with advantages in recovery and post- operative morbidity. It allows type fast track with short hospital stay times. This approach enabled radical lymphadenec- tomy with low respiratory impact.