SSAT - INITIAL EXPERIENCE IN MINIMAL INVASIVE OESOPHAGECTOMY IN A TERTAIRY CARE UNIT IN A DEVELOPING COUNTRY

Back to 2018 Posters

INITIAL EXPERIENCE IN MINIMAL INVASIVE OESOPHAGECTOMY IN A TERTAIRY CARE UNIT IN A DEVELOPING COUNTRY
Chathuranga T. Keppetiyagama^*
Gastroeneterological Surgery, Teaching Hospital Kandy, Sri Lanka, Galle, Southern Province, Sri Lanka

Background
Introduction of minimally invasive techniques has improved outcome in Oesophegectomy. Thoracoscopy and laparoscopy are used completely minimally invasive fashion or hybridized with open procedure. This is a descriptive study
Objectives
Evaluate outcomes of minimally invasive oesophagectomy
Methods
There were 45 patients diagnosed having oesophageal cancer from 01.06.2016 to 20.11.2017. All patients were directed to MDT. There were 20 patients underwent laparoscopic oesophagectomy. Duration of surgery, blood loss post-operative ITU stay, and complications were documented. Patients were nil by mouth for 5days. Leak test was done 5-7 days.

Results
Twenty patients had oesophagectomy. Ten (16/20) patients had SCC( Squamous cell cancer) while other four are Adenocarcinoma. Location of the tumour was four(4/20) mid oesophageal, 12/20 lower oesophageal and 4/12 were at gastro-oesophageal junction(GOJ). 10 received neoadjuvant, other 10had primary surgery. All the patients had at least once postponement due to unavailability of ITU beds. 3 patients underwent Thoracolaparoscopic Mckeowns and others had Laparoscopic assisted Ivor Lewis. 3/20 had hand sewn anastomosis others had circular stapler anastomosis.Time required in each part in minutes are thoracoscopy 148, laparoscopy 133.5 and thoracotomy 154.
One patient was abandoned due to invasion of aorta. Blood loss in each part, thoracoscopy < 10ml, laparoscopy < 10ml and thoracotomy 145 ml in average. Post-operative ITU stay was 2.3 days. 8/20 patients had lung infections,one had chyle leak managed thoracoscopic ligation,and 2/20 had wound infection. None of the patients had an anastomotic leak or mortality.
Conclusion
Oesophageal cancers are detected at advanced state and majority are SCC. Minimally invasive oesophagectomy has low morbidity and zero mortality.

Back to 2018 Posters