Hand-assisted laparoscopic and thoracoscopic surgery (HALTS) in radical esophagectomy with three-field lymphadenectomy for thoracic esophageal cancer

Aim: To prove the feasibility of hand-assisted laparoscopic and thoracoscopic surgery (HALTS) for radical esophagectomy with three-field lymphadenectomy to thoracic esophageal cancer. Methods: Esophagectomy with three-field lymphadenectomy was performed using HALTS in 19 patients with thoracic esophageal. cancer without distant metastasis. Five patients had chemo-radiotherapy prior to surgery. Results: All. operations were completed successfully without the need for open surgery. Mean surgical time was 476 +/- 58 min, and mean blood toss during surgery was 343 +/- 184 mL. All. patients started tube feeding and were moved from the intensive care unit to the general. surgery ward the day after surgery. Discharge occurred a median of 10 days after surgery. Fifteen patients could return to full time jobs from 8 to 62 days after surgery (median 22 days) and from 1 to 35 days after discharge (median 9 days). Other three could return to daily activities at home soon as welt. No major complications occurred, except one anastomotic teak. In terms of lung function, %FEV1 was not changed whereas %VC was reduced significantly 1 month after surgery. All but two recurrences have been healthy without a relapse for a mean of 289 days. Conclusions: These results suggest that HALTS may be a useful. surgical technique to reduce the invasiveness of conventional radical esophagectomy with three-field lymphadenectomy for thoracic esophageal cancer. (C) 2005 Elsevier Ltd. All rights reserved.