Minimally invasive abdominal and left thoracic approach for Siewert type II adenocarcinoma of the oesophagogastric junction: Novel technique for simultaneous combined use of laparoscopy and thoracoscopy.

BACKGROUND

The optimal approach to resection for Siewert type II adenocarcinoma of the oesophagogastric junction (AEG) is still controversial. Our novel procedures and experience with a minimally invasive abdominal and left thoracic approach (MALTA) for Siewert type II AEG are described.

PATIENTS AND METHODS

Intra- and post-operative outcomes for MALTA were assessed in seven consecutive patients with a preoperative diagnosis of Siewert type II AEG at Hokkaido University Hospital.

RESULTS

None of the patients were converted to open surgery. The mean surgical duration was 434.0 ± 71.4 min, and mean blood loss was 20.7 ± 16.7 ml. On pathological examination, the median proximal margin was 24.6 ± 12.5 mm. No reoperations were needed, and there were no surgery-related complications.

CONCLUSIONS

This novel technique shows considerable advantages, such as ensuring the proximal margin, intrathoracic oesophagojejunostomy and increased operative field exposure of the lower mediastinal area for Siewert type II AEG.