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> Totally laparoscopic trans-hiatal gastroesophagectomy for benign diseases of the esophago-gastric junction

AIM : To present prospectively our initial experience with totally laparoscopic transhiatal esophagogastrectomies for benign diseases of the cardia and distal esophagus.

METHODS : Laparoscopic gastric mobilization and tubularization combined with transhiatal esophageal dissection and intrathoracic esophagogastric anastomosis accomplished by a circular stapler was done in 3 patients. There were 2 females and 1 male patient with a mean age of 73 ± 5 years.

RESULTS : Two patients were operated on due to benign stromal tumor of the cardia and one patient had severe oesophageal peptic stenosis. Mean blood loss was 47 ± 15 mL and mean operating time was 130 ± 10 min. There were no cases that required conversion to laparotomy. All patients were extubated immediately after surgery. Soft diet intake and ambulation times were 5.1 ± 0.4 d and 2.6 ± 0.6 d, respectively. There were no intraoperative and postoperative complications and there were no perioperative deaths. The average length of hospital stay was 9.3 ± 3 d. All procedures were curative and all resected margins were tumor free. The mean number of retrieved lymph nodes was 18 ± 8.

CONCLUSION : Laparoscopic transhiatal esophago-gastrectomy for benign lesions has good effects and proves feasible and safe.

Jean-Louis Dulucq

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