Intracorporeal manual esophagogastric anastomosis in minimally invasive subtotal esophagectomy using the Ivor Lewis technique

Objective. Description and standardization of the proposed technique for forming an intracorporeal manual esophagogastric anastomosis (EGA) during minimally invasive subtotal esophagectomy (SE) of the Ivor Lewis type and analysis of the immediate results of its application Material and methods. The study included 13 patients who underwent minimally invasive (thoracoscopic-laparoscopic) Ivor Lewis SE with the formation of a single-layer manual end-to-side anastomosis. The mean age of the patients was 57 years, including 9 men (69.3%) and 4 women (30.7%). Indications for surgery were esophageal cancer in 3 (23.1%) patients, cardioesophageal cancer (Siewert I—II) in 7 (53.8%), and extensive cicatricial strictures in 3 (23.1%). Results. The mean duration of surgery was 423 minutes, and the anastomosis formation time was 41.4 minutes. Complications in the early postoperative period were observed in 3 (23.1%) patients, including one case of EGA failure. The results are comparable with data from other studies, confirming the safety of the technique. Conclusion. The use of a modified intracorporeal manual EGA in minimally invasive Ivor Lewis surgery demonstrates safety and efficacy comparable to global literature data. Further evaluation of the technique requires multicenter prospective studies using a standardized approach.