Initial experience with minimally invasive Ivor Lewis esophagectomy.

Background: We have previously reported our experience with minimally invasive esophagectomy. Our standard approach involves laparoscopic and thoracoscopic mobilization of the esophagus with a cervical esophagogastric anastomosis. In the present study we report our early experience with a modification of this technique, in which a high intrathoracic anastomosis is performed.

Barrett's esophagus: diagnostic approaches and surveillance.

In an effort to identify those patients at risk for developing esophageal adenocarcinoma, the American College of Gastroenterology recommends screening endoscopy in patients with chronic gastroesophageal reflux disease. Surveillance endoscopy is recommended every 3 years in those patients without dysplasia. For those patients with verified low-grade dysplasia, yearly surveillance endoscopy is recommended.

Minimally invasive operation for esophageal diverticula.

Background: Mid and lower esophageal diverticula are rare entities usually managed by open operation. Morbidity can be significant with these complex procedures. This study evaluates our results of minimally invasive surgery for esophageal diverticula.

Efficacy of laparoscopic fundoplication in controlling pulmonary symptoms associated with gastroesophageal reflux disease.

Background: Gastroesophageal reflux disease (GERD)-induced pulmonary symptoms (PS) can be difficult to control. The effectiveness of laparoscopic fundoplication (LF) in controlling PS among patients with medically recalcitrant GERD is poorly documented. We evaluated our results in controlling important PS in patients with GERD undergoing LF.

Current staging of esophageal carcinoma.

The rational treatment of esophageal cancer requires the complete evaluation and preoperative staging of this disease. As the incidence of esophageal cancer increases, more clinicians will face the difficult task of allocating the appropriate treatment course for these patients. Accurate esophageal cancer staging is critical if stage-dependent algorithms are used to direct appropriate therapies.

Thoracic epidural versus intercostal nerve catheter plus patient-controlled analgesia: a randomized study.

Background: Pain control is an important issue after thoracotomy. Ideal methods should have a high success rate, with easy implementation and minimal complications. Debate exists over the optimal pain control method.

Radiofrequency ablation for the treatment of non-small cell lung cancer in marginal surgical candidates.

Objective: Treatment options for patients with non-small cell lung cancer who are not surgical candidates or who refuse operation are limited. Radiofrequency ablation represents a potential less invasive option for these patients. Our initial experience with radiofrequency ablation for peripheral, primary non-small cell lung cancer is reported.

Laparoscopic Roux-en-Y gastric bypass for recalcitrant gastroesophageal reflux disease in morbidly obese patients.

Background And Objectives: Gastroesophageal reflux disease (GERD) is commonly associated with morbid obesity (MO). Antireflux surgery has a higher failure rate in MO and addresses only one of the comorbidities present. This paper reviews the results of laparoscopic Roux-en-Y gastric bypass (LRYGBP) performed for recalcitrant GERD in MO.

Comparison of mutational changes in involved N1 lymph nodes with those in primary tumors in stage II non-small cell lung cancer: a pilot study.

Objectives: Surgical resection is the standard treatment for stage II non-small cell lung cancer, but recurrence rates approach 60%. This study compared mutational changes in involved lymph nodes and primary tumors from patients with stage II non-small cell lung cancer to determine whether risk factors for recurrence could be identified.

Methods: Forty patients with resected stage II non-small cell lung cancer (excluding T3 N0 disease) were studied.

Outcomes of minimally invasive antireflux operations in the elderly: a comparative review.

Background And Objectives: The objectives of this study were to assess the impact of age following laparoscopic fundoplication (LF).

Methods: From March 1993 to November 1998, 193 patients underwent LF. Patients comprised 150 young individuals (age<60; median 41) and 43 older individuals (age>60; median 68).

Photodynamic therapy as palliation for esophageal cancer: experience in 215 patients.

Background: Photodynamic therapy (PDT) utilizes a photosensitizing agent, light, and oxygen to endoscopically ablate cancer cells. This review summarizes our experience with PDT for the palliation of bleeding or obstructing esophageal cancer (EC).

Methods: All patients with bleeding or obstructing EC treated with PDT from November 1996 through June 2002, were reviewed.

Minimally invasive esophagectomy: outcomes in 222 patients.

Objective: To assess our outcomes after minimally invasive esophagectomy (MIE).

Summary Background Data: Esophagectomy has traditionally been performed by open methods. Results from most series include mortality rates in excess of 5% and hospital stays frequently greater than 10 days.

Photodynamic therapy for endobronchial metastases from nonbronchogenic primaries.

Background: Endobronchial metastases (EBM) occur in 2% of nonbronchogenic malignancies and frequently present with hemoptysis or dyspnea. This report summarizes our recent experience with photodynamic therapy (PDT) for EBM.

Methods: All patients who have undergone PDT for the treatment of symptomatic EBM from nonbronchogenic primaries were identified in the Division of Thoracic Surgery database to determine number of treatments, frequency of symptom relief, and patient survival.

Radiofrequency ablation of pulmonary malignant tumors in nonsurgical candidates.

Objective: Radiofrequency ablation applies thermal energy with a catheter delivery system, resulting in coagulation necrosis. Radiofrequency ablation is frequently used for hepatic malignant tumors, but few reports exist regarding its use for lung tumors. We report our experience with radiofrequency ablation for the treatment of pulmonary malignant tumors.

Results of laparoscopic repair of giant paraesophageal hernias: 200 consecutive patients.

Background: Giant paraesophageal hernias (GPEH) have traditionally required open operations. Increasingly, a laparoscopic approach is being applied to more complex esophageal surgery. Our objective was to update our growing experience with laparoscopic repair of GPEH.

Minimally invasive esophagectomy in the elderly.

Objectives: In recent years, older patients are being referred for esophagectomy, and the associated morbidity and mortality is not well defined. Advances in minimally invasive techniques now allow minimally invasive esophagectomy (MIE) to be performed that may minimize the morbidity of this procedure. The objective of this report was to summarize our experience with MIE in the elderly.

Minimally invasive resection for esophageal cancer.

MIE is technically demanding with a steep learning curve. Operative times decrease from 7 to 8 hours to 4.5 to 5 hours after the surgeons and assistants in the authors' center had performed 20 operations.

Outcomes after minimally invasive reoperation for gastroesophageal reflux disease.

Background: Reoperative antireflux surgery is complex and traditionally performed by open methods. Increasingly, surgeons are performing minimally invasive reoperations. This report summarizes our experience with laparoscopic reoperative antireflux surgery (LRAS).