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Conference Paper: Modern surgery for esophageal cancer

TitleModern surgery for esophageal cancer
Authors
Issue Date2014
PublisherThe Congress.
Citation
The 2014 Joint Meeting of the World Association for Bronchology and Interventional Pulmonology and the International Bronchoesophagology Society, Kyoto, Japan, 13-16 April 2014 How to Cite?
AbstractSurgical treatment for esophageal cancer has made great progress in the past decades. It used to be a procedure of high mortality rate. With improvement in surgical techniques and peri-operative care, esophagectomy has been made relatively safe. In specialized centers, a mortality rate of less than 5% can be achieved. Morbidity rates remain high. The invasive surgery, especially with extended lymphadenectomy, performed on an elderly population with comorbidities, has its associated complications. Survival after treatment has improved, especially with increasing use of multimodality strategies. Minimally invasive surgery in the form of video-assisted thoracoscopic +/- laparoscopic esophagectomy, has become more popular. Equivalent, or even superior lymphadenectomy can be performed compared to open surgery. Some debatable aspects of minimally invasive esophagectomy remain, including its appropriate indication, lateral position vs. prone position, whether an intrathoracic or cervical esophageal anastomosis should be performed, and whether laparoscopic gastric mobilization should be an integral part of the procedure in addition to thoracoscopy, and if so, should the gastric conduit be prepared intra-corporeally or extra-corporeally. In over 200 minimally invasive esophagectomy performed at The University of Hong Kong, a mortality rate of 1% was achieved. Equivalent lymph node harvesting and survival was found compared to open surgery. Only one European multicenter randomized trial has been conducted comparing minimally invasive esophagectomy and open transthoracic resection. Less pulmonary complications were found. More trials are needed to truly prove its benefits. The results of surgery will improve further. The challenge of modern surgery is how best to individualize surgical procedures for patients with different stages of disease, comorbidities, and after neoadjuvant therapies.
DescriptionSymposium 4: Modern surgery for esophagus cancer: no. E-SY4-1
Persistent Identifierhttp://hdl.handle.net/10722/197716

 

DC FieldValueLanguage
dc.contributor.authorLaw, Sen_US
dc.date.accessioned2014-05-29T08:45:24Z-
dc.date.available2014-05-29T08:45:24Z-
dc.date.issued2014en_US
dc.identifier.citationThe 2014 Joint Meeting of the World Association for Bronchology and Interventional Pulmonology and the International Bronchoesophagology Society, Kyoto, Japan, 13-16 April 2014en_US
dc.identifier.urihttp://hdl.handle.net/10722/197716-
dc.descriptionSymposium 4: Modern surgery for esophagus cancer: no. E-SY4-1-
dc.description.abstractSurgical treatment for esophageal cancer has made great progress in the past decades. It used to be a procedure of high mortality rate. With improvement in surgical techniques and peri-operative care, esophagectomy has been made relatively safe. In specialized centers, a mortality rate of less than 5% can be achieved. Morbidity rates remain high. The invasive surgery, especially with extended lymphadenectomy, performed on an elderly population with comorbidities, has its associated complications. Survival after treatment has improved, especially with increasing use of multimodality strategies. Minimally invasive surgery in the form of video-assisted thoracoscopic +/- laparoscopic esophagectomy, has become more popular. Equivalent, or even superior lymphadenectomy can be performed compared to open surgery. Some debatable aspects of minimally invasive esophagectomy remain, including its appropriate indication, lateral position vs. prone position, whether an intrathoracic or cervical esophageal anastomosis should be performed, and whether laparoscopic gastric mobilization should be an integral part of the procedure in addition to thoracoscopy, and if so, should the gastric conduit be prepared intra-corporeally or extra-corporeally. In over 200 minimally invasive esophagectomy performed at The University of Hong Kong, a mortality rate of 1% was achieved. Equivalent lymph node harvesting and survival was found compared to open surgery. Only one European multicenter randomized trial has been conducted comparing minimally invasive esophagectomy and open transthoracic resection. Less pulmonary complications were found. More trials are needed to truly prove its benefits. The results of surgery will improve further. The challenge of modern surgery is how best to individualize surgical procedures for patients with different stages of disease, comorbidities, and after neoadjuvant therapies.-
dc.languageengen_US
dc.publisherThe Congress.-
dc.relation.ispartof18th WCBIP / WCBE World Congress 2014 Program & Abstractsen_US
dc.titleModern surgery for esophageal canceren_US
dc.typeConference_Paperen_US
dc.identifier.emailLaw, S: slaw@hku.hken_US
dc.identifier.authorityLaw, S=rp00437en_US
dc.description.naturelink_to_OA_fulltext-
dc.identifier.hkuros228862en_US
dc.publisher.placeJapan-

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