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Related Concept Videos

Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

139
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
139

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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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Minimally Invasive Modified McKeown Esophagectomy.

Ealaf Shemmeri1, Jon O Wee2

  • 1Division of Thoracic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.

Surgical Oncology Clinics of North America
|May 24, 2024
PubMed
Summary

McKeown esophagectomy, a transthoracic approach with cervical anastomosis, offers reduced pain and hospital stays for esophageal conditions. Despite ongoing challenges like anastomotic leaks, improved complication management makes it a viable surgical option.

Keywords:
Anastomotic leakEsophageal cancerMcKeown esophagectomyMinimally invasiveRobotic McKeown

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • McKeown esophagectomy is a standard surgical technique for esophageal diseases.
  • The procedure involves a transthoracic approach with a cervical anastomosis.
  • It has undergone significant modifications over time.

Purpose of the Study:

  • To review the current status and modifications of the McKeown esophagectomy.
  • To evaluate the benefits and persistent challenges of this surgical approach.
  • To highlight advancements in managing complications associated with the procedure.

Main Methods:

  • Review of current literature on McKeown esophagectomy modifications.
  • Comparison of minimally invasive/robotic techniques with open esophagectomy.
  • Analysis of complication rates and management strategies.

Main Results:

  • The latest McKeown esophagectomy versions use robotic or minimally invasive ports in the chest and abdomen.
  • Minimally invasive approaches show decreased pain and shorter hospital stays compared to open surgery.
  • Anastomotic leak and recurrent laryngeal nerve injury remain significant complications.

Conclusions:

  • Despite potential complications, advancements in managing them have reduced mortality.
  • McKeown esophagectomy, particularly its minimally invasive forms, remains a relevant and effective option for esophageal pathologies.
  • Ongoing refinements continue to improve patient outcomes for this established procedure.