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Thoracoscopic-Laparoscopic Ivor Lewis-McKeown Esophagectomy

  • Yi Zhang
  • Fusheng Zou
  • Ruihua Duan
  • Xiangfeng Xiao
  • Yong Zhang
Chapter

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.

Keywords

Ivor Lewis-McKeown Superior esophageal cancer Lymph node dissection Anastomosis Position 

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Copyright information

© Springer Nature Singapore Pte Ltd. and Huazhong University of Science and Technology Press 2018

Authors and Affiliations

  • Yi Zhang
    • 1
  • Fusheng Zou
    • 2
  • Ruihua Duan
    • 2
  • Xiangfeng Xiao
    • 2
  • Yong Zhang
    • 2
  1. 1.Thoracic DepartmentThird Affiliated Hospital of Jianghan UniversityWuhanChina
  2. 2.Department of Cardiothoracic SurgeryThe Third Affiliated Hospital of Jianghan UniversityWuhanChina

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