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Thoracoscopic-Laparoscopic Ivor Lewis-McKeown Esophagectomy

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Atlas of Thoracoscopic-lapacoscopic Esophagectomy

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Abstract

The Ivor Lewis-McKeown surgery is mainly indicated by patients with regional lymph node metastasis in the superior portion of the thoracic esophagus and resectable tumor.

Before surgery, a patient should undergo examinations such as CT scans of the chest and abdomen, EUS, and laparoscopic staging to identify any remarkable tumor metastasis. The thoracoscopic esophagectomy does not contraindicate neoadjuvant radiotherapy or chemotherapy. The operation generally begins from the chest to the neck and then to the stomach and is finished with a cervical esophagogastric anastomosis; in some cases, a surgeon first mobilizes the cervical esophagus and the stomach, dissects the cervical and abdominal lymph nodes, and anastomoses the esophagus and stomach in the neck before resecting the thoracic esophagus.

The Ivor Lewis-McKeown surgery ensures a favorable exposure of endoscopic operative field for the complete resection of the invaded superior esophageal and the thoracic, abdominal, and cervical lymph node dissection. But China has not accepted it for extensive use as it causes unignorable injuries and requires changing patient position twice during surgery.

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Authors and Affiliations

  1. Thoracic Department, Third Affiliated Hospital of Jianghan University, Wuhan, China

    Yi Zhang

  2. Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Jianghan University, Wuhan, China

    Fusheng Zou, Ruihua Duan, Xiangfeng Xiao & Yong Zhang

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  1. Yi Zhang
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  4. Xiangfeng Xiao
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  1. Thoracic Department, Third Affiliated Hospital of Jianghan University, Wuhan, China

    Yi Zhang

  2. Department of Cardiothoracic Surgery, Tongji Hospital, Wuhan, China

    Tiecheng Pan

  3. Department of Cardiothoracic Surgery, Tongji Hospital, Wuhan, China

    Xiang Wei

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Zhang, Y., Zou, F., Duan, R., Xiao, X., Zhang, Y. (2018). Thoracoscopic-Laparoscopic Ivor Lewis-McKeown Esophagectomy. In: Zhang, Y., Pan, T., Wei, X. (eds) Atlas of Thoracoscopic-lapacoscopic Esophagectomy. Springer, Singapore. https://doi.org/10.1007/978-981-10-7569-8_4

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