scholarly journals Efficacy and Safety of Continuous Paravertebral Block after Minimally Invasive Radical Esophagectomy for Esophageal Cancer

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Shifa Zhang ◽  
Hongfeng Liu ◽  
Haibo Cai
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Adverse Reactions ◽  
Postoperative Recovery ◽  
Pulmonary Complications ◽  
Paravertebral Block ◽  
Radical Esophagectomy ◽  
Visual Analogue Pain ◽  
Intravenous Analgesia ◽  
Vas Scores

Objective. To compare the effects of continuous paravertebral block analgesia and patient-controlled intravenous analgesia after minimally invasive radical esophagectomy for esophageal cancer and their effects on postoperative recovery. Methods. A retrospective analysis was performed among 233 patients who underwent minimally invasive esophageal cancer radical operation and met the requirements, including 87 patients (group C) who were successfully placed with a continuous paravertebral block device under direct vision and 146 patients (group P) who used a patient-controlled intravenous analgesia device. Visual analogue pain score (VAS) at rest and in motion for 1, 3, 6, 12, 24, 36, and 48 hours after awakening, incidence of adverse reactions of the two analgesic methods, occurrence of pulmonary complications after operation, use of emergency analgesics, and hospital stay after operation was recorded. Results. The VAS scores of group C in resting and active state at 1, 3, 6, 12, 24, 36, and 48 hours after operation were significantly lower than those of group P (P<0.001). The incidence of adverse reactions, pulmonary complications, and the use of emergency analgesics in group C were lower than those in group P (P<0.05). The hospitalization time of group C was significantly shortened, and the satisfaction degree of group C was significantly higher than that of group P (P<0.05). Conclusion. Paravertebral block is safe and effective for patients undergoing minimally invasive radical esophagectomy. The incidence of adverse reactions and complications is lower, and the satisfaction of postoperative analgesia is higher, which is beneficial to the rapid recovery of patients after operation.

351 SINGLE-PORT MINIMALLY INVASIVE ESOPHAGECTOMY TO TREAT ESOPHAGEAL CANCER: EXPERIENCE OF 144 CASES

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Jang-Ming Lee ◽  
Chen Ke-Cheng ◽  
Lin Mong-Wei ◽  
Yang Pei-Wen ◽  
Huang Pei-Ming
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Single Incision ◽  
Single Port ◽  
Minimally Invasive Esophagectomy ◽  
Pulmonary Complications ◽  
Term Survival ◽  
Invasive Esophagectomy ◽  
Laparoscopic Procedures ◽  
The Mean

Abstract   Single-incision thoracoscopic and laparoscopic procedures has have been applied in treating various diseases. However, it is limited in literature for such procedures used in treating esophageal cancer. Methods Minimally invasive esophagectomy (MIE) with a single-incision approach in the thoracoscopic and laparoscopic procedures was attempted in 144 patients with esophageal cancer. Results There was 96 patients underwent a McKeown procedure and 48 an Ivor Lewis procedure repectively. The mean ventilator usage of the patients after surgery was 0.3 ± 0.6 days, the mean ICU stay was 7.42 ± 17.15 days, and the mean number of dissected lymph nodes was 43.5 ± 21.8. There 11 patients suffered from postoperative complications, including 3 pulmonary complications, 4 anastomotic leakage and 4 vocal cord palsy. There are no 30-day mortality, however, there were one patient died from ARDS 40 days after surgery. Conclusion Single-port MIE seems to be a feasible option for treating patients with esophageal cancer, which offers an acceptable perioperative surgical outcome. However, the long-term survival results of the patients requires to be follow-up in the future.

Minimally invasive radical esophagectomy for esophageal cancer

Esophagus ◽  
2007 ◽  
Vol 4 (2) ◽  
pp. 59-65 ◽  
Author(s):  
Hirokazu Noshiro ◽  
Eishi Nagai ◽  
Shuji Shimizu ◽  
Akihiko Uchiyama ◽  
Masayuki Kojima ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Radical Esophagectomy

Minimally Invasive Esophagectomy

2019 ◽  
pp. 308-318
Author(s):  
Brandon Merling ◽  
Frank Dupont
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Anesthetic Management ◽  
Pulmonary Complications ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Perioperative Morbidity ◽  
Invasive Esophagectomy ◽  
Common Causes

Esophageal cancer is the eighth most common malignancy worldwide, producing a high morbidity and mortality rate around the globe. Minimally invasive esophagectomy (MIE) is most commonly performed on patients with this devastating disease. Esophagectomy is a high-risk procedure, and perioperative mortality remains around 5%–8%. Because esophageal cancer is associated with chronic alcohol and tobacco use, patients have serious comorbid conditions that affect anesthetic management and perioperative care. Among them, pulmonary complications and anastomotic failure remain the most common causes of perioperative morbidity and mortality. The anesthesiologist managing a patient during MIE must be able to reduce the effect of the patient’s multiple comorbidities intraoperatively while mitigating the factors that lead to adverse postoperative outcomes.

303 LONG-TERM SURVIVAL AND PULMONARY COMPLICATIONS IN MEDIASTINOSCOPIC ESOPHAGECTOMY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Hirotaka Konishi
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Cancer Progression ◽  
Pulmonary Complication ◽  
Pulmonary Complications ◽  
Recurrent Nerve ◽  
Radical Esophagectomy ◽  
Term Survival ◽  
Nerve Paralysis

Abstract   The radical esophagectomy for esophageal cancer is an invasive therapy due to a long one-lung ventilation. The mediastinoscopic esophagectomy in consideration of pulmonary complications became eligible for Japanese health insurance. Methods Radical esophagectomies (R0/1, gastric tube reconstruction) by thoracotomy/thoracoscopy (groupT) or mediastinoscopy (groupM) were performed for 118/58 or 225 patients with esophageal cancer. The long-term therapeutic results of mediastinoscopic radical esophagectomy are investigated. Results In clinicopathological features, younger and lower PS patients, neoadjuvant chemotherapy, advanced cases, or R1 resection were more frequent in groupT (p &lt; 0.01). Pulmonary complication was not significantly different in both groups (15.5 vs 11.0%, p = 0.19), whereas the any complications, including the recurrent nerve paralysis, were significantly frequent in groupM. The 5-years overall survival was better in group M (53.0% vs 68.2%, p = 0.04), but it may be because of the difference of cancer progression. In the subgroup analysis, the overall survival rate was similar in each clinical stage. The survival of patients with pulmonary complication was significantly worse in groupT. Conclusion The survival of patients underwent trans-mediastinoscopic radical esophagectomy was not different from that with conventional esophagectomy. The influence of pulmonary complications on survival may be lower in mediastinoscopic esophagectomy.

scholarly journals Outcomes after decompressive laminectomy for lumbar spinal stenosis: comparison between minimally invasive unilateral laminectomy for bilateral decompression and open laminectomy

2014 ◽  
Vol 21 (2) ◽  
pp. 179-186 ◽  
Author(s):  
Ralph Jasper Mobbs ◽  
Jane Li ◽  
Praveenan Sivabalan ◽  
Darryl Raley ◽  
Prashanth J. Rao
Keyword(s):  
Minimally Invasive ◽  
Short Form ◽  
Surgical Techniques ◽  
Postoperative Recovery ◽  
Leg Pain ◽  
Study Patient ◽  
Pain Patient ◽  
Opioid Use ◽  
Satisfaction Index ◽  
Vas Scores

Object The development of minimally invasive surgical techniques is driven by the quest for better patient outcomes. There is some evidence for the use of minimally invasive surgery for degenerative lumbar spine stenosis (LSS), but there are currently no studies comparing outcomes with matched controls. The object of this study was to compare outcomes following minimally invasive unilateral laminectomy for bilateral decompression (ULBD) to a standard “open” laminectomy for LSS. Methods The authors conducted a prospective, 1:1 randomized trial comparing ULBD to open laminectomy for degenerative LSS. The study enrolled 79 patients between 2007 and 2009, and adequate data for analysis were available in 54 patients (27 in each arm of the study). Patient demographic characteristics and clinical characteristics were recorded and clinical outcomes were obtained using pre- and postoperative Oswestry Disability Index (ODI) scores, visual analog scale (VAS) scores for leg pain, patient satisfaction index scores, and postoperative 12-Item Short Form Health Survey (SF-12) scores. Results Significant improvements were observed in ODI and VAS scores for both open and ULBD interventions (p < 0.001 for both groups using either score). In addition, the ULBD-treated patients had a significantly better mean improvement in the VAS scores (p = 0.013) but not the ODI scores (p = 0.055) compared with patients in the open-surgery group. ULBD-treated patients had a significantly shorter length of postoperative hospital stay (55.1 vs 100.8 hours, p = 0.0041) and time to mobilization (15.6 vs 33.3 hours, p < 0.001) and were more likely to not use opioids for postoperative pain (51.9% vs 15.4%, p = 0.046). Conclusions Based on short-term follow-up, microscopic ULBD is as effective as open decompression in improving function (ODI score), with the additional benefits of a significantly greater decrease in pain (VAS score), postoperative recovery time, time to mobilization, and opioid use.

PS02.023: SINGLE-INCISION MINIMALLY INVASIVE ESOPHAGECTOMY FOR TREATING ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 126-126
Author(s):  
Jang-Ming Lee ◽  
Sunn-Mao Yang ◽  
Pei-Ming Huang
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Anastomotic Leakage ◽  
Single Incision ◽  
Conflicts Of Interest ◽  
Minimally Invasive Esophagectomy ◽  
Vocal Cord Palsy ◽  
Pulmonary Complications ◽  
Invasive Esophagectomy ◽  
Matched Comparison

Abstract Background Single-incision throacoscopic and laparoscopic procedure has been applied to treating various diseases. In the current study, we applied this novel surgical technique in the minimally invasive esophagectomy for esophageal cancer. Methods Minimally invasive esophagectomy (MIE) with single-port approach in the thoracoscopic and laparoscopic procedures was attempted for patients with esophageal cancer. Patients with esophageal cancer who underwent MIE from 2006 to 2016 were evaluated. A 3–4 cm incision was created both in the thoracoscopic and the laparoscopic phases during the single-incision MIE procedures. A propensity-matched comparison was made between the two groups of patients with single-incision and multi-incision MIE. Results We analyzed a total of 48 pairs of patients with propensity-matched from the cohort of 360 patients undergoing MIE during 2006–2015. There were 12 patients having postoperative complications (25%), including 4 (8.3%) of anastomotic leakage one (2.1%) of pulmonary complications and 3 (6.3%) with vocal cord palsy in the patients undergoing single-incision MIE (SIMIE). There is no statistical difference in terms of postoperative ICU and hospital stay, number of dissected lymph nodes and presence of major surgical complications (anastomotic leakage and pulmonary complications) between the two groups of patients. The pain score one week after surgery was significantly lower in the single-incision group (P < 0.05). There was no surgical mortality in the single-incision MIE group. Conclusion Minimally invasive esophogectomy performed with a single-incision approach is feasible for treating patients with esophageal cancer, with a comparable perioperative outcome with that of multi-incision approaches. The postoperative pain one week after surgery was significantly reduced in patients undergoing single-incision MIE. Disclosure All authors have declared no conflicts of interest.

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