Transcervical Endoscopic Esophageal Mobilization: An Approach to Transhiatal Esophagectomy

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Traditional transhiatal esophagectomy is associated with significant operative time and blood loss.
• Transcervical endoscopic esophageal mobilization (TEEM) was developed to mitigate these challenges.

Purpose of the Study:

• To evaluate the safety and efficacy of TEEM esophagectomy.
• To assess perioperative outcomes and survival rates associated with the TEEM approach.

Main Methods:

• Retrospective chart review of 241 patients undergoing TEEM esophagectomy (2009-2020).
• Data collected included baseline characteristics, operative details, and postoperative complications.
• Kaplan-Meier survival analysis was performed.

Main Results:

• Mean operative time: 185.1 minutes; Mean blood loss: 251.4 mL.
• Common postoperative complications included hoarseness (28.2%) and atrial fibrillation (25.7%).
• 30-day mortality: 2.1%; 90-day mortality: 4.6%; Median survival: 2.36 years.

Conclusions:

• TEEM esophagectomy is a safe procedure with acceptable morbidity and mortality.
• This technique offers shorter operative times compared to historical transhiatal esophagectomy standards.
• TEEM esophagectomy demonstrates favorable survival outcomes for patients.