The patient was a 59-year-old woman with malignant neoplasm of middle third of esophagus and intrahepatic cholangiocarcinoma admitted to the hospital for a transthoracic esophagectomy
. Four days after the procedure, the patient was transferred to the Adult Intensive Care Unit (ICU) due to hemodynamic instability and ventilatory discomfort.
The general intention of surgeons is to perform a standard transhiatal or transthoracic esophagectomy
with colonic interposition or gastric pull-up procedure for benign end-stage and premalignant or in situ malignant lesions of the esophagus.
This surgery, a robotic transthoracic esophagectomy
, uses minimally invasive robotics to remove an esophageal tumor.
Currently, transthoracic esophagectomy
with radical lymphadenectomy followed by postoperative adjuvant chemotherapy or radiotherapy is the standard curative treatment for locally advanced esophageal cancer .
Bueno et al., "Transthoracic esophagectomy
with radical mediastinal and abdominal lymph node dissection and cervical esophagogastrostomy for esophageal carcinoma," The Annals of Thoracic Surgery, vol.
All patients had esophageal carcinoma and had undergone previous transthoracic esophagectomy
van der Horst et al., "Robot-assisted minimally invasive thoraco-laparoscopic esophagectomy versus open transthoracic esophagectomy
for resectable esophageal cancer, a randomized controlled trial (ROBOT trial)," Trials, vol.
Outcomes after transhiatal and transthoracic esophagectomy
Conventionally, a transthoracic esophagectomy
(TTE) have been practiced for esophageal cancers of middle and upper esophagus and a transhiatal esophagectomy (THE) performed for cases where the mass is low and accessible through the hiatus.
Fluid management and postoperative respiratory disturbances in patients with transthoracic esophagectomy
Previously, it was considered that transthoracic esophagectomy
is the standard of care for oncological resection, but Orringer challenged this claim in the 1970s and redescribed the transhiatal procedure as equally effective but less morbid than transthoracic procedure owing to less postoperative pulmonary complications .
Transhiatal and transthoracic esophagectomy
: A comparative study.