TY - JOUR
T1 - Mediastinal Tracheostomy With Vessel Transposition and Minimally Invasive Transhiatal Esophagectomy
AU - Grant, Christa N.
AU - Marshall, M. Blair
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - As surgical outcomes and survival of patients with cancer improves, in particular patients with head and neck cancer would often develop multiple primaries. The limitations of radiation for repeated local therapy leave radical surgery as the only local option for some of these patients. Given the complexity of the issues at hand, these patients should be evaluated by a multidisciplinary team with expertise in otolaryngology, radiation oncology, medical oncology, and thoracic surgery. Mediastinal tracheostomy is rarely used, but it can be a useful tool in the management of these complex patients. When esophagectomy is performed in combination with pharyngolaryngectomy, a minimally invasive transhiatal approach can be used. Transhiatal esophageal mobilization is technically feasible with laparoscopy, and it obviates the need for thoracic incisions and patient repositioning in this already complex morbid procedure. Additionally, for cervical esophageal tumors, neither margins nor completeness of lymphadenectomy are sacrificed. We describe several critical steps of mediastinal tracheostomy and minimally invasive transhiatal esophagectomy for the management of these complex patients.
AB - As surgical outcomes and survival of patients with cancer improves, in particular patients with head and neck cancer would often develop multiple primaries. The limitations of radiation for repeated local therapy leave radical surgery as the only local option for some of these patients. Given the complexity of the issues at hand, these patients should be evaluated by a multidisciplinary team with expertise in otolaryngology, radiation oncology, medical oncology, and thoracic surgery. Mediastinal tracheostomy is rarely used, but it can be a useful tool in the management of these complex patients. When esophagectomy is performed in combination with pharyngolaryngectomy, a minimally invasive transhiatal approach can be used. Transhiatal esophageal mobilization is technically feasible with laparoscopy, and it obviates the need for thoracic incisions and patient repositioning in this already complex morbid procedure. Additionally, for cervical esophageal tumors, neither margins nor completeness of lymphadenectomy are sacrificed. We describe several critical steps of mediastinal tracheostomy and minimally invasive transhiatal esophagectomy for the management of these complex patients.
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U2 - 10.1053/j.optechstcvs.2016.10.004
DO - 10.1053/j.optechstcvs.2016.10.004
M3 - Article
AN - SCOPUS:85006306445
VL - 21
SP - 47
EP - 64
JO - Operative Techniques in Thoracic and Cardiovascular Surgery
JF - Operative Techniques in Thoracic and Cardiovascular Surgery
SN - 1522-2942
IS - 1
ER -