368. UNIPORTAL VATS MCKEOWN ESOPHAGECTOMY FOR LOWER THIRD ESOPHAGEAL SQUAMOUS CELL CANCER

https://wetransfer.com/downloads/bc83bc97967d74f093629397fd7b5ed720230505000919/8c1e7aa0e8a6b089152303025bfbfd7120230505000947/ff511d

Background

Minimally invasive esophagectomy has become the standard surgical procedure for the carcinoma esophagus worldwide. It is performed with multiport VATS or robotically. Uniport VATS technique has gained a recent popularity among thoracic surgeons for resecting lung cancers. Here we describe our technique of performing uniportal McKeown esophagectomy in semi prone position without using carbon dioxide.

Methods

The surgery was performed on a middle aged male patient who was diagnosed with a locally advanced squamous cell cancer of lower third of the esophagus. Multidisciplinary meeting planned three cycles of Docetaxel, cisplatin and 5 fluorouracil regimen and subsequent surgery was planned after patient had a partial response.

Results

The thoracic phase was performed by uniport VATS and abdominal phase was performed by standard multiport technique. Neck anastomosis was performed with linear stapler in side to side manner. Total time of the surgery was 280 minutes. Intraoperative and postoperative period was uneventful. Patient was discharged home on ninth postoperative day on oral diet.

Conclusion

Uniportal VATS McKeown Esophagectomy is a feasible and safe technique with all short term advantages of minimally invasive approach. The coaxial ergonomics together with the semi prone positioning, allows the best surgical maneuvering.