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Article: Pharyngolaryngoesophagectomy using the thoracoscopic approach

TitlePharyngolaryngoesophagectomy using the thoracoscopic approach
Authors
KeywordsComplications
Esophageal neoplasm
Minimally invasive surgery
Mortality
Survival
Thoracoscopy
Issue Date2007
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/
Citation
Surgical Endoscopy And Other Interventional Techniques, 2007, v. 21 n. 6, p. 879-884 How to Cite?
AbstractBackground: Thoracoscopic mobilization of the esophagus for pharyngolaryngoesophagectomy allows dissection under direct vision, and therefore it potentially results in fewer complications than conventional transhiatal mobilization. In this article we report our experience with this approach. It was also hypothesized that a learning curve existed and that results have improved over time. Patients and methods: From July 1994 until January 2004, 57 patients underwent pharyngolaryngoesophagectomy in our institution. Intraoperative events and postoperative outcome were prospectively documented, and long-term follow-up data were also studied. Results were compared between the first 30 patients and the last 27 patients. Results: There were no significant differences between the two groups with respect to the various clinicopathological characteristics. There was no difference in the median thoracoscopic time between the first 30 and last 27 patients at 90 and 75 min, respectively, p = 0.18. For the complete procedure there was significantly less blood loss in the later group; median (range) blood loss 700 (164-3000) ml versus 400 (100-1200) ml, p = 0.002. Overall pulmonary complications occurred in 12 patients (40%) in the first group versus 13 (48%) in the second group, p = 0.6. The incidence of atrial arrhythmia was also similar, affecting 6 (20%) patients and 3 (11%), respectively, p = 0.47. Hospital mortality rates were 13.3% and 7.4%, p = 0.67. Two-year survival rates were no different (46% versus 45% p = 0.85). Conclusions: Although, subjectively, operating skills have improved over time, better results in the second half of this series could not be demonstrated clearly, likely because the operating surgeons had prior extensive experience in esophageal and thoracoscopic procedures. © 2006 Springer Science+Business Media, LLC.
Persistent Identifierhttp://hdl.handle.net/10722/83874
ISSN
2015 Impact Factor: 3.54
2015 SCImago Journal Rankings: 1.695
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorCense, HAen_HK
dc.contributor.authorLaw, Sen_HK
dc.contributor.authorWei, Wen_HK
dc.contributor.authorLam, LKen_HK
dc.contributor.authorNg, WMen_HK
dc.contributor.authorWong, KHen_HK
dc.contributor.authorKwok, KFen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:46:15Z-
dc.date.available2010-09-06T08:46:15Z-
dc.date.issued2007en_HK
dc.identifier.citationSurgical Endoscopy And Other Interventional Techniques, 2007, v. 21 n. 6, p. 879-884en_HK
dc.identifier.issn0930-2794en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83874-
dc.description.abstractBackground: Thoracoscopic mobilization of the esophagus for pharyngolaryngoesophagectomy allows dissection under direct vision, and therefore it potentially results in fewer complications than conventional transhiatal mobilization. In this article we report our experience with this approach. It was also hypothesized that a learning curve existed and that results have improved over time. Patients and methods: From July 1994 until January 2004, 57 patients underwent pharyngolaryngoesophagectomy in our institution. Intraoperative events and postoperative outcome were prospectively documented, and long-term follow-up data were also studied. Results were compared between the first 30 patients and the last 27 patients. Results: There were no significant differences between the two groups with respect to the various clinicopathological characteristics. There was no difference in the median thoracoscopic time between the first 30 and last 27 patients at 90 and 75 min, respectively, p = 0.18. For the complete procedure there was significantly less blood loss in the later group; median (range) blood loss 700 (164-3000) ml versus 400 (100-1200) ml, p = 0.002. Overall pulmonary complications occurred in 12 patients (40%) in the first group versus 13 (48%) in the second group, p = 0.6. The incidence of atrial arrhythmia was also similar, affecting 6 (20%) patients and 3 (11%), respectively, p = 0.47. Hospital mortality rates were 13.3% and 7.4%, p = 0.67. Two-year survival rates were no different (46% versus 45% p = 0.85). Conclusions: Although, subjectively, operating skills have improved over time, better results in the second half of this series could not be demonstrated clearly, likely because the operating surgeons had prior extensive experience in esophageal and thoracoscopic procedures. © 2006 Springer Science+Business Media, LLC.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/en_HK
dc.relation.ispartofSurgical Endoscopy and Other Interventional Techniquesen_HK
dc.subjectComplicationsen_HK
dc.subjectEsophageal neoplasmen_HK
dc.subjectMinimally invasive surgeryen_HK
dc.subjectMortalityen_HK
dc.subjectSurvivalen_HK
dc.subjectThoracoscopyen_HK
dc.titlePharyngolaryngoesophagectomy using the thoracoscopic approachen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0930-2794&volume=21&issue=6&spage=879&epage=884&date=2007&atitle=Pharyngolaryngoesophagectomy+using+the+thoracoscopic+approachen_HK
dc.identifier.emailLaw, S: slaw@hku.hken_HK
dc.identifier.emailWei, W: hrmswwi@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLaw, S=rp00437en_HK
dc.identifier.authorityWei, W=rp00323en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00464-006-9049-zen_HK
dc.identifier.pmid17103269-
dc.identifier.scopuseid_2-s2.0-34447320513en_HK
dc.identifier.hkuros131905en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34447320513&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume21en_HK
dc.identifier.issue6en_HK
dc.identifier.spage879en_HK
dc.identifier.epage884en_HK
dc.identifier.isiWOS:000247190400009-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridCense, HA=8982324100en_HK
dc.identifier.scopusauthoridLaw, S=7202241293en_HK
dc.identifier.scopusauthoridWei, W=7403321552en_HK
dc.identifier.scopusauthoridLam, LK=7201984637en_HK
dc.identifier.scopusauthoridNg, WM=7401613513en_HK
dc.identifier.scopusauthoridWong, KH=36485841700en_HK
dc.identifier.scopusauthoridKwok, KF=7102194177en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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