Laparoscopic-Assisted Transhiatal Esophagectomy (LATE) for Carcinoma of the Esophagus

Total laparoscopic approach for the management of carcinoma of the esophagus has not gained much popularity due to its complexity. The aim of this study was to evaluate safety, feasibility, and outcome of laparoscopic-assisted transhiatal esophagectomy (LATE) for patients with carcinoma of the esophagus. This retrospective study involves a total of 26 patients with carcinoma of the esophagus who were considered for LATE by a single surgical team from January 2010 to September 2014. The median (range) age was 55 years (35-72), and male to female ratio was 20:6. The median (range) operative time, blood loss, and hospital stay were 300 min (180-660), 300 ml (100-500), and 11.5 days (8-25), respectively. Pulmonary complications and cervical anastomotic leak (including one patient with conduit necrosis) occurred in eight (30.7 %) and three (11.5 %) patients, respectively. AJCC stage (7th ed.) was IIA in 12 (46.15 %), IIB in 10 (38.46 %), IIIA in 3 (11.53 %), and IIIB in 1 (3.84 %) patient. Surgical resection margin was negative in all but one patient (3.8 %). The median (range) number of lymph nodes (LN) retrieved was 13 (8-28). During a median follow-up 19 months (8-39), five patients (19.23 %) developed recurrence and three (11.5 %) of them died. LATE is a safe and feasible for the management of selected patients with carcinoma of the lower thoracic esophagus.