LAPAROSCOPIC TRANSHIATAL ESOPHAGECTOMY FOR ADVANCED THORACIC ESOPHAGEAL CANCER

We performed transhiatal subtotal esophagectomy under laparoscopic gui dance to reduce the invasiveness of subtotal esophagectomy while prese rving dissectional accuracy. In six cases of advanced thoracic esophag eal cancer with distant metastasis, we used a special type of handpiec e of ultrasonic surgical aspirator (CUSA) for laparoscopic surgery to dissect the esophagus from surrounding tissues and to isolate vessels entering it while viewing with the video monitor. Hemostasis of isolat ed vessels was effected by clips or electrocoagulation. There was no m assive bleeding from the mediastinum during the operation, nor was the re postoperative bleeding or infection. All patients regained normal s wallowing ability and were discharged. Transhiatal esophagectomy under laparoscopic guidance is considered a safe, less invasive operative t reatment for patients who are suffering from advanced thoracic esophag eal cancer.