P167 MINIMALLY-INVASIVE 3-STAGE ESOPHAGECTOMY FOR CANCER WITH COLONIC INTERPOSITION: THE INITIAL EXPERIENCE IN A TERTIARY CENTER

Abstract

Abstract Aim First choice for restoration of the gastrointestinal tract after esophagectomy is gastric conduit, however when stomach is unavailable as in history of gastrectomy, concurrent gastric disease or gastric cancer, colon or subsequently jejenum can be used as an esophageal substitute. The aim of this study is to discuss safety, technique and feasibility of colonic interposition, in the era of minimally invasive surgery in a tertiary esophageal centre. Background & Methods From 01/09/2018 to 01/06/19, two patients with esophageal cancer underwent Hybrid 3-stage esophagectomy, using the left colon as an esophageal conduit, in our department. Both patients were objected to thoracoscopic esophageal mobilization, in prone position. The patients were then turned to supine position and laparotomy was performed. Colonic conduit was prepared, transferred to the left neck in a posterior mediastinal position and a handsewn oesophagocolonic anastomosis was performed. Clinicopathological outcomes were studied. Results Mean operative time was 420 minutes and mean blood loss was 160cc. No intraoperative complications were reported. The mean time of Intensive care unit stay of our patients was 6 days and mean duration of hospital stay was 25 days. Postoperative complications observed was 1 contralateral pneumothorax and 1 ipsilateral pneumonia. R0 resection was achieved in both patients. Mean lymph nodes harvested were 45. Both patients were discharged in good clinical condition. Conclusion Hybrid 3-stage esophagectomy with colonic interposition may be a safe and feasible technique when performed in an experienced Upper Gastrointestinal Surgical Department Unit.