Request PDF on ResearchGate | On Jan 1, , E. Pérez-Rodríguez and others published Linfangiomiomatosis y quilotorax. Conflictos en el manejo del. El presente estudio analizó la efectividad del manejo conservador, incluyendo pleurodesis, del quilotórax como complicación de la resección. Laparoscopic transhiatal esophagectomy with Akiyama tube reconstruction for a terminal achalasia. AM Pereira, R Ferreira de Almeida, G Gonçalves.
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Thoracoscopic esophageal diverticulectomy and myotomy. The treatment consists in a diverticulectomy combined with an esophageal myotomy, which aims to treat motor disorders and to prevent fistula at the level of the diverticulectomy area. Intraoperative diagnosis of short esophagus in a patient with Barrett’s metaplasia. Routine intraoperative endoscopy and liberal addition of a Collis gastroplasty is a key factor to prevent recurrences.
Laparoscopic enucleation of a horseshoe-shaped leiomyoma of the distal esophagus. This is the case of a year-old girl, complaining of weight loss and dysphagia. In the preoperative work-up, gastroscopy and endoscopic ultrasonography revealed a cm multilobulated submucosal mass. Computed tomography and MRI showed a distal esophageal mass of 4cm in diameter. Fine needle aspiration biopsy was compatible with a leiomyoma. The patient was admitted to hospital for surgery, and a laparoscopic transhiatal enucleation of the esophageal leiomyoma was performed.
The first assistant stood on the right side of the patient and the second assistant on the left.
The procedure was performed using 5 trocars. The phrenoesophageal membrane was divided. The distal esophagus was circumferentially mobilized. Dissection was started by separating the layer over the tumor.
Blunt dissection was preferred.
The use of energy devices discouraged to prevent any delayed mucosal burn injury. The leiomyoma was completely enucleated. Esophageal muscle layers were closed. The postoperative period was uneventful.
This video demonstrates technical details of a laparoscopic enucleation of a hoseshoe-shaped leiomyoma of the distal esophagus. Quilotoorax management of chylothorax after esophagectomy. Optimal management of chylothorax can decrease mortality. It is based on three options: In case of either high flow rate chylothorax or failure of conservative treatment, reoperation is indicated.
Two cases of postoperative chylothorax successfully managed thoracoscopically are reported. This video demonstrates a patient with epiphrenic esophageal diverticulum.
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The patient first undergoes a laparoscopic Heller’s myotomy but does not experience significant improvement in his symptoms. Subsequently the patient undergoes a diverticulectomy through a right thoracoscopic approach. Totally thoracoscopic and laparoscopic Ivor Lewis esophagectomy in obese patients. Totally thoracoscopic and laparoscopic Ivor Lewis esophagectomy using a circular stapler or manual anastomosis has recently been described by a few authors.
We performed this challenging technique with a completely thoracoscopic hand-sewn esophagogastric anastomosis in two quilitorax patients in prone position one female and one maleaffected manej an adenocarcinoma of the lower third of the esophagus without lymph node invasion pT2 N0 and with a BMI of 35 and 32 respectively.
The first female patient is the subject of this video. Thoracoscopy lasted minutes anastomosis was 50 minutes longlaparoscopy lasted minutes, and second laparoscopy lasted 20 minutes.
Blood loss was estimated at mL.
Manejo toracoscópico de quilotórax após esofagectomia
The gastrografin swallows on postoperative day 7 in both patients showed absence of stenosis and leak. The patients had an uneventful postoperative course and were discharged on postoperative day 12 and 10, respectively. Thoracoscopy in prone position allows the surgeon to perform a thoracoscopic esophagogastric anastomosis completely hand-sewn without selective lung exclusion, and using only three trocars. In obese patients, although the technique is foremost challenging, the advantages of minimally invasive surgery are undeniable —better intraoperative respiratory function avoiding selective lung exclusion and less complicated postoperative course.
Laparoscopic Heller myotomy for the treatment of esophageal achalasia. The treatment of achalasia has undergone a dramatic evolution over the past years with the introduction of advanced laparoscopic techniques. In this video, a Heller myotomy in a year-old patient suffering from esophageal achalasia is demonstrated. Laparoscopic transhiatal esophagectomy for adenocarcinoma of the lower esophagus.
Conventional esophagectomy requires either a laparotomy with a transhiatal dissection or a laparotomy combined with thoracotomy and it is associated with significant morbidity and mortality. In the attempt to decrease morbidity, some surgeons have reported the application of minimally invasive technique of resection of the esophagus.
Quilotorax post quirúrgico by marco rojas on Prezi
De Paula was the first maneio report a large series of 48 patients undergoing a total laparoscopic transhiatal esophagectomy LTH. LTH may be used to treat patients with either benign or malignant esophageal disease because the reconstructive result cervical esophagogastric anastomosis yields good functional outcomes. Here we show the case of a LTH for adenocarcinoma of the lower esophagus.
Thoracoscopic resection of an esophageal leiomyoma.
Nearly two thirds of benign tumors are leiomyomas. They usually arise as intramural growths, most commonly along the distal two thirds dfl the esophagus. They have extremely small potential for malignant degeneration. Surgical excision is recommended for symptomatic great lesions. The video demonstrates the thoracoscopic qkilotorax of a leiomyoma on the upper thoracic third of the esophagus with the patient in a prone position, which brings an excellent exposure of the operative field and decreases lung injuries as we do not use any retractor.
Thoracoscopic resection of thoracic esophageal diverticula. The description of the thoracoscopic resection of thoracic esophageal diverticula covers all aspects of the surgical procedure used for the management of thoracic esophageal diverticula.
Operating room set up, position manej patient and equipment, instruments used are thoroughly described. The technical key steps of the surgical procedure are presented in a step by step way: Consequently, this operating technique is well standardized for the management of this condition.