Endoscopic oesophagectomy through a right thoracoscopic approach

Area of Science:

• Thoracic Surgery
• Gastrointestinal Endoscopy
• Surgical Oncology

Background:

• Esophageal cancer and benign motility disorders require effective surgical interventions.
• Minimally invasive techniques are increasingly preferred to reduce patient morbidity.
• Thoracoscopic approaches offer potential advantages in esophageal surgery.

Purpose of the Study:

• To describe and evaluate a subtotal endoscopic oesophagectomy technique.
• To assess the feasibility and outcomes of the right thoracoscopic approach for oesophagectomy.
• To report perioperative data including blood loss, operative time, and hospital stay.

Main Methods:

• A right thoracoscopic approach was utilized for subtotal endoscopic oesophagectomy.
• The technique was applied to five patients: four with esophageal cancer and one with a benign motility disorder.
• Perioperative data, including blood loss, operative duration, intensive care unit stay, and hospital stay, were recorded.

Main Results:

• Operative blood loss was unmeasurable in four of five patients and 300 ml in one.
• The mean duration for endoscopic dissection was 3.3 hours (range 3.0-4.0 hours).
• The mean total procedure duration was 5.5 hours (range 4.5-7.5 hours), with a mean intensive care unit stay of 19.5 hours and a mean hospital stay of 11 days.

Conclusions:

• Subtotal endoscopic oesophagectomy via the right thoracoscopic approach is a feasible technique.
• The procedure is associated with minimal operative blood loss and manageable operative times.
• Further investigation is warranted to fully establish the long-term efficacy and safety profile of this approach.