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 HOW I DO IT
Year : 2020  |  Volume : 16  |  Issue : 3  |  Page : 285-288

Minimally invasive abdominal and left thoracic approach for Siewert type II adenocarcinoma of the oesophagogastric junction: Novel technique for simultaneous combined use of laparoscopy and thoracoscopy


Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan

Correspondence Address:
Dr. Yuma Ebihara
Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, N15w7, Kita-Ku, Sapporo, Hokkaido 060-8638
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmas.JMAS_228_17

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Background: The optimal approach to resection for Siewert type II adenocarcinoma of the oesophagogastric junction (AEG) is still controversial. Our novel procedures and experience with a minimally invasive abdominal and left thoracic approach (MALTA) for Siewert type II AEG are described. Patients and Methods: Intra- and post-operative outcomes for MALTA were assessed in seven consecutive patients with a preoperative diagnosis of Siewert type II AEG at Hokkaido University Hospital. Results: None of the patients were converted to open surgery. The mean surgical duration was 434.0 ± 71.4 min, and mean blood loss was 20.7 ± 16.7 ml. On pathological examination, the median proximal margin was 24.6 ± 12.5 mm. No reoperations were needed, and there were no surgery-related complications. Conclusions: This novel technique shows considerable advantages, such as ensuring the proximal margin, intrathoracic oesophagojejunostomy and increased operative field exposure of the lower mediastinal area for Siewert type II AEG.






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