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EARLY POSTOPERATIVE REHABILITATION (FAST TRACK) AFTER LAPARO-THORACOSCOPIC RE-SECTION OF TH E PROX IMAL STOMACH AND TH ORACIC ESOPH AG US ABOUT CARD IOESOPH AG EAL CANCER

Abstract

An obstacle to the use of minimally invasive video-endoscopic approaches for radical surgical operations for cardioesophageal cancer is the need of resection and lymphadenectomy in the two anatomical areas. The resolution of the problem of injuries surgical accesses actualizes the problem of optimal postoperative management of these patients. In 2015-16, we performed 27 resection of the proximal stomach and lower esophagus with one-stage intrapleural esophagogastroplasty a combined laparoscopic and right thoracoscopic access. Prevailed patients in III stage of disease - 9 14 (51,9 %) patients. In 4 cases ( 14,8%) cases were identified with stage IV. R0 resection was performed in 24 (88,9%) patients, R1 - 3 (11,1 %). Histological examination was studied on average 42±3 lymph node. The advantages of radical operations for cardioesophageal cancer a combined laparoscopic and right thoracoscopic approaches: the clarity of the visualization, good control of hemostasis, ease of mobilization of the stomach and esophagus, early activation of patients in the postoperative period (4 days), reduced length of hospital stay (7.3 days). The use of early rehabilitation after surgery technology (ERAS or “fast-track”) allows to reduce the duration of hospitalization, accelerate recovery and rehabilitation of patients.

About the Authors

A. S. Allakhverdyan
THORACIC SURGERY DEPARTMENT # MOSCOW REGIONAL RESEARCH AND CLINICAL INSTITUTE (“MONIKI”)
Russian Federation


A. M. Ovezov
THORACIC SURGERY DEPARTMENT # MOSCOW REGIONAL RESEARCH AND CLINICAL INSTITUTE (“MONIKI”)
Russian Federation


N. N. Anipchenko
THORACIC SURGERY DEPARTMENT # MOSCOW REGIONAL RESEARCH AND CLINICAL INSTITUTE (“MONIKI”)
Russian Federation


A. N. Anipchenko
THORACIC SURGERY DEPARTMENT # MOSCOW REGIONAL RESEARCH AND CLINICAL INSTITUTE (“MONIKI”)
Russian Federation


References

1. Черноусов А.Ф., Черноусов Ф.А., Хоробрых Т.В., Вычужа- нин Д.В. Хирургиче-ское лечение больных кардиоэзофагеальным раком.// Вестник хирургической гастроэнтерологии. - 2009 - №2 - С. 67-77

2. Давыдов М.И., Туркин И.Н., Стилиди И.С. и др. Кардиоэзо- фагеальный рак: классификация, хирургическая тактика, основные факторы прогноза.// Вестник РОНЦ им. Н.Н. Блохина РАМН. - 2003 - №1 - С. 82-89

3. Siewert J.R., Feith M., Stein H.J. Biologic and clinical variations of adenocarcinoma at the esophago-gastric junction: relevance of a topo- graphic-anatomic subclassification. J Surg Oncol. 2005 Jun 1; 90(3): 139-46

4. Orringer M.B., Marshall B., Chang A.C., et al. Two thousand tran- shiatal esophagectomies: changing trends, lessons learned. Ann Surg. - 2007- V 246 - p. 363-372

5. Sasako M., Sano T., Yamamoto S. et al. Left thoracoabdominal approach versus abdominal-transhiatal approach for gastric cancer of the cardia or subcardia: a randomized controlled trial. // Lancet Oncol. - 2006- №7 - р. 644-651

6. Стилиди И. С., Рябов А. Я., Бохян В. Ю. и др. Оптимизиро- ванный абдомино-медиастинальный доступ в хирургии рака желудка с переходом на пищевод.// Вестник РОНЦ им. Н.Н. Блохина РАМН. - 2006 - т. 17, № 4 - С. 47-51

7. ыхно Ю.А., Самотесов П.А., Батухтина Ю.В. Топографо- анатомическое обос-нование хирургического доступа при кардио- эзофагеальном раке в зависимости от типа телосложения// Сибирский онкологический журнал - 2004- №4 (12) - С. 42-47

8. Esquivel C.M., Ampudia C., Fridman A. et al. Technique and out- comes of laparoscopic-combined linear stapler and hand-sutured side-to- side esophagojejunostomy with Roux-en-Y reconstruction as a treatment modality in patients undergoing proximal gastrectomy for benign and ma- lignant disease of the gastroesophageal junction. // Surg Laparosc Endosc Percutan Tech. - 2014 - Feb; 24(1) - p. 89-93

9. Израилов Р.Е., Васнев О.С., Кошкин М.А. с соавт. Возмож- ности лапароскопиче-ской хирургии в лечении раков кардиоэзофа- геального перехода.// «Альманах Института хирургии имени А.В. Вишневского». Тезисы докладов xVIII съезда Общества эндоскопи- ческих хирургов России. 17-19 февраля 2015г - г. Москва 2015 - №1- С. 494

10. Montenovo M.I., Chambers K., Pellegrini C.A., Oelschlager B.K. Outcomes of lapa-roscopic-assisted transhiatal esophagectomy for adeno- carcinoma of the esophagus and esophago-gastric junction.// Dis Esopha- gus. - 2011 - Aug;24(6) - р. 430-436

11. Maas K.W., Biere S.S., Scheepers J.J. et al. Laparoscopic versus open transhiatal esophagectomy for distal and junction cancer. // Rev Esp Enferm Dig.- 2012 - Apr;104(4)- p. 197-202

12. Liu Hong, Yujie Zhang, Hongwei Zhang, Jianjun Yang, Qingch- uan Zhao The Short-Term Outcome of Three-Field Minimally Invasive Esophagectomy for Siewert Type I Esophagogastric Junctional Adenocar- cinoma. //Ann Thorac Surg- 2013 - V. 96 - p. 1826-1832

13. Gemmill E.H., Humes D.J., Catton J.A. Systematic review of en- hanced recovery after gastro-oesophageal cancer surgery.// Ann R Coll Surg Engl. - 2015 -Apr;97(3)- p.173-179


Review

For citations:


Allakhverdyan A.S., Ovezov A.M., Anipchenko N.N., Anipchenko A.N. EARLY POSTOPERATIVE REHABILITATION (FAST TRACK) AFTER LAPARO-THORACOSCOPIC RE-SECTION OF TH E PROX IMAL STOMACH AND TH ORACIC ESOPH AG US ABOUT CARD IOESOPH AG EAL CANCER. Moscow Surgical Journal. 2017;(4):8-12. (In Russ.)

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ISSN 2072-3180 (Print)