Minimally Invasive Oesophagectomy (MIO) is now established as a valid alternative to open surgery for the management of oesophago-gastric cancers. However, a high incidence of ischaemia related gastric conduit failure (ICF) is observed which is detrimental to any potential benefits of this approach.
METHODS AND PROCEDURES
MIO has been the procedure of choice for oesophago-gastric resection in our unit since April 2004.This involves a thoracoscopic and laparoscopic oesophageal and gastric mobilisation, resection and conduit formation, with a cervical anastomosis. Data relating to the surgical technique was collected, with focus on ischaemic conditioning by laparoscopic ligation of the left gastric artery (LIC) at two weeks, or five days prior to resection. A prospective longitudinal study was simultaneously set up to collect data on health related quality of life using the validated EORTC QLQ-C30 and OES18 questionnaires.
97 patients underwent a planned MIO. There were 4 in-patient deaths (mortality 4.1%) and overall 21 patients (21.6%) developed ICF. 54 patients did not undergo ischaemic conditioning and conduit failure was observed in 11 (20.4%). 36 patients had a laparoscopic ischaemic conditioning at two weeks and 3 (8.3%) had ICF whilst all 7 patients who had LIC at 5 days had ICF (100%). Timing of ischaemic conditioning (p
Session: Podium Presentation
Program Number: S035