Esophageal Cancer
Conditions
Brief summary
Thoraco-laparoscopic partial esophagogastrectomy has emerged as a promising minimally invasive alternative, combining thoracoscopy and laparoscopy to reduce the trauma associated with open surgery.Early and intermediate-term outcomes provide critical information on both the oncological efficacy and functional benefits of the procedure. By examining recurrence rates within the first 12-24 months, this study will provide valuable insights into the oncological robustness of this approach compared to more invasive approaches.
Interventions
PROCEDUREThoraco-laparoscopic partial esophagogastrectomy
1. Laparoscopic Phase: * The stomach is mobilized, and a part of it is resected to include the lower esophageal segment. * Left gastric nodes, the splenic and common hepatic nodes are dissected. * A gastric tube is created using endoscopic staplers for esophageal reconstruction and fixed to the proximal gastrectomy specimen using sutures 2. Thoracoscopic Phase: * The patient is positioned in prone position * Three small incisions are made in the thorax * Further esophageal mobilization through a right thoracoscopy is performed in left lateral decubitus. Periesophageal nodes are retrieved en bloc. Left and right paratracheal and subcarinal lymph nodes are resected separately. The esophagus is transected at the tumor's proximal margin. 3. Reconstruction: * An anastomosis (esophagogastric connection) is performed to restore continuity, typically using a circular stapler or hand-sewn technique.
Sponsors
Mansoura University
Sohag University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients diagnosed with resectable esophageal cancer (stages I-III). * Suitable for thoraco-laparoscopic partial esophagogastrectomy. * Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
Exclusion criteria
* Presence of distant metastasis at diagnosis. * History of previous esophageal or gastric surgery. * Contraindications to laparoscopy or thoracoscopy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| regurgitation | Collected at one month, and 12 months post-surgery. | yes or no |
| Dysphagia | Collected at base line preoperative,one month, and 12 months post-surgery. | yes or no |
| resection margin status | 2 weeks postoperative | resection margin status (R0/R1/R2) |
| lymph node yield. | first month post operative | number of lymph nodes in specimen |
| Immediate Postoperative complications | first month post operative | 30-day morbidity and mortality (using Clavien-Dindo classification) |
Secondary
| Measure | Time frame |
|---|---|
| body mass index | Collected at base line preoperative,one month, and 12 months post-surgery. |
| serum albumin | Collected at base line preoperative,one month, and 12 months post-surgery. |
| recurrence rate | first year post operative |
Countries
Egypt
Contacts
Primary Contactahmed m salah eldin, assistant lecturer of general
Outcome results
None listed