SlideShare a Scribd company logo

Laparoscopic trans hiatal esophagectomy for early cancer-final

•Download as PPT, PDF•
•
foregutsurgeon
foregutsurgeon
Health & Medicine
1 of 25
Laparoscopic Trans-Hiatal Esophagectomy for Early Cancer Abeezar I. Sarela Department of Upper GI & Minimally Invasive Surgery Leeds, UK
SAGES Presenter Disclosure Slide Abeezar I. Sarela Nothing To Disclose
Agenda Early Esophageal Carcinoma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is Early Esophageal Cancer? Superficial Esophageal Carcinoma Japanese Esophageal Society Esophagus 2009;6:1-25 T1a + T1b AJCC/TNM 7 th Edition Early Esophageal Carcinoma Japanese Esophageal Society Esophagus 2009;6:1-25 T1a AJCC/TNM 7th Edition
pT1 Esophageal Carcinoma Depth of primary tumor and lymph node metastasis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Stein et al. Ann Surg 2005;242:566-573
Subclassification of Depth of Invasion by Superficial Carcinoma of the Esophagus in Surgically Resected Specimens Endoscopic Resection Specimens sm1 carcinoma: invades less than 200 microns into the submucosa Japanese Esophageal Society. Japanese Classification of Esophageal Cancer. !0 th Ed. Esophagus 2009;6:1-25
Relationship between Depth of Invasion and Lymph Node Metastasis in Superficial Squamous Carcinoma Takubo et al. Histopathology 2007;51:733-742
Relationship between Depth of Invasion and Lymph Node Metastasis in Superficial Adenocarcinoma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Westerterp et al. Virchows Arch 2005;446:497-504
Oncological Outcomes Esophagectomy for pT1 Adenocarcinoma Saha et al. Surg Endosc 2009;23:119-124 40 patients - T1b 11 patients - N1 20% of T1b - Poor differentiation 4 patients Liver 22 N0 Poor T1a Trans-thoracic Liver 8 N1 Poor T1b Trans-thoracic Nodes 6 N0 Poor T1b Trans-Hiatal Site of recurrence Time to recurrence Node status Differentiation Tumor Depth Operation
Diagnosis and Staging of Early (T1a) and Superficial (T1a+T1b) Esophageal Carcinoma
Endoscopic Diagnosis of Early Esophageal Carcinoma Fujinon “FICE” Olympus “Tri-Modality”
Can we predict the risk of lymph node metastasis? 27% 50% 20% 10% 10% Incidence of nodal metastasis Takubo et al. Histopathology 2007;51:733-742
High Risk Factors for Lymph Node Metastasis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Takubo et al. Histopathology 2007;51:733-742
Endoscopic Ultrasound (EUS) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Endoscopic Mucosal Resection ,[object Object],[object Object]
Emerging Treatment Paradigm EMR of all resectable dysplastic lesions Favourable histology? Multifocality? Ablation of the remaining Barrett‘s - ?RFA Endoscopic Surveillance
Indications for Esophagectomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Transhiatal vs. Transthoracic? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Hulscher et al. N Eng J Med 2002;347:1662-9; Omloo et al. Ann Surg 2007;246:992-1000
Laparoscopic Transhiatal Esophagectomy ,[object Object],[object Object],[object Object],[object Object],[object Object],Decker et al. European Journal of Cardio-Thoracic Surgery. 2009;35:13-21
Laparoscopic Esophagectomy Transhiatal vs. Transthoracic Decker et al. European Journal of Cardio-Thoracic Surgery. 2009;35:13-21 17 (7-62) 10 (5-15) Lymph node count 2.4% 4.6% Mortality 6.8% 3% Re-operation 22% 22% Respiratory complic. 7.6% 13% Leakage 6.4% 10% Vocal cord palsy Transthoracic 1499 patients Transhiatal 433 patients
What is the Aim of Esophagectomy? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laparoscopic Vagus-Sparing Esophagectomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Peyre et al. Ann Surg 2007;246:665-671 DeMeester S. Personal communication, 2010
Segmental Resection of the Gastroesophageal Junction and Reconstruction with a Pedicled Flap of Jejunum (Merindino Operation) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Stein et al. Ann Surg 2000;232:733-742
 
Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Recommended

Notes
Notes Notes
Notes Mounika Thommandru
 
Conduits after esophagectomy for esophageal reconstruction
Conduits after esophagectomy for esophageal reconstruction Conduits after esophagectomy for esophageal reconstruction
Conduits after esophagectomy for esophageal reconstruction Shahbaz Panhwer
 
Surgical Management of Carcinoma Esophagus
Surgical Management of Carcinoma EsophagusSurgical Management of Carcinoma Esophagus
Surgical Management of Carcinoma EsophagusDr.Bhavin Vadodariya
 
Component seperation technique for the repair of very large ventral hernias
Component seperation technique for the repair of very large ventral hernias Component seperation technique for the repair of very large ventral hernias
Component seperation technique for the repair of very large ventral hernias nikhilameerchetty
 
Pancreatic Trauma
Pancreatic TraumaPancreatic Trauma
Pancreatic TraumaJibran Mohsin
 
Single Incision Laparoscopic Surgery
Single Incision Laparoscopic SurgerySingle Incision Laparoscopic Surgery
Single Incision Laparoscopic SurgerySumit Roy
 
Multidisciplinary Approach to Colorectal Liver Metastases
Multidisciplinary Approach to Colorectal Liver MetastasesMultidisciplinary Approach to Colorectal Liver Metastases
Multidisciplinary Approach to Colorectal Liver MetastasesPradeep Dhanasekaran
 
Barrett’s surveillance and early management of ca oesophagus
Barrett’s surveillance and early management of ca oesophagusBarrett’s surveillance and early management of ca oesophagus
Barrett’s surveillance and early management of ca oesophagusElmuhtady Said FRCP FEBGH
 

Recommended

Notes
Notes Notes
Notes Mounika Thommandru
 
Conduits after esophagectomy for esophageal reconstruction
Conduits after esophagectomy for esophageal reconstruction Conduits after esophagectomy for esophageal reconstruction
Conduits after esophagectomy for esophageal reconstruction Shahbaz Panhwer
 
Surgical Management of Carcinoma Esophagus
Surgical Management of Carcinoma EsophagusSurgical Management of Carcinoma Esophagus
Surgical Management of Carcinoma EsophagusDr.Bhavin Vadodariya
 
Component seperation technique for the repair of very large ventral hernias
Component seperation technique for the repair of very large ventral hernias Component seperation technique for the repair of very large ventral hernias
Component seperation technique for the repair of very large ventral hernias nikhilameerchetty
 
Pancreatic Trauma
Pancreatic TraumaPancreatic Trauma
Pancreatic TraumaJibran Mohsin
 
Single Incision Laparoscopic Surgery
Single Incision Laparoscopic SurgerySingle Incision Laparoscopic Surgery
Single Incision Laparoscopic SurgerySumit Roy
 
Multidisciplinary Approach to Colorectal Liver Metastases
Multidisciplinary Approach to Colorectal Liver MetastasesMultidisciplinary Approach to Colorectal Liver Metastases
Multidisciplinary Approach to Colorectal Liver MetastasesPradeep Dhanasekaran
 
Barrett’s surveillance and early management of ca oesophagus
Barrett’s surveillance and early management of ca oesophagusBarrett’s surveillance and early management of ca oesophagus
Barrett’s surveillance and early management of ca oesophagusElmuhtady Said FRCP FEBGH
 
Laparoscopic Herniorrhaphy: TEP
Laparoscopic Herniorrhaphy: TEPLaparoscopic Herniorrhaphy: TEP
Laparoscopic Herniorrhaphy: TEPGeorge S. Ferzli
 
Ivor lewis esophagectomy
Ivor lewis esophagectomyIvor lewis esophagectomy
Ivor lewis esophagectomyrajat1906
 
Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface Malignancies
Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface MalignanciesHyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface Malignancies
Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface MalignanciesMary Ondinee Manalo Igot
 
Stents in surgery
Stents in surgeryStents in surgery
Stents in surgerySharath !!!!!!!!
 
Damage Control Surgery
Damage Control SurgeryDamage Control Surgery
Damage Control Surgerynational hosp abuja
 
Crs+hipec— jeddah,
Crs+hipec— jeddah,Crs+hipec— jeddah,
Crs+hipec— jeddah,Basalama Ali
 
Component separation for ventral hernias prof. ahm shamsul alam
Component separation for ventral hernias prof. ahm shamsul alamComponent separation for ventral hernias prof. ahm shamsul alam
Component separation for ventral hernias prof. ahm shamsul alamnoel alam
 
LAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptx
LAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptxLAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptx
LAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptxSelvaraj Balasubramani
 
Intestinal transplant
Intestinal transplantIntestinal transplant
Intestinal transplantMahesh Raj
 
Component separation technique for a very large abdominal wall hernia
Component separation technique for a very large abdominal wall herniaComponent separation technique for a very large abdominal wall hernia
Component separation technique for a very large abdominal wall herniaSanjiv Haribhakti
 
Intestinal anastomosis and staplers
Intestinal anastomosis and staplersIntestinal anastomosis and staplers
Intestinal anastomosis and staplersUnit 6 surgery lok nayak hospital
 
Laparoscopic Colon Resection - Anterior Approach
Laparoscopic Colon Resection - Anterior ApproachLaparoscopic Colon Resection - Anterior Approach
Laparoscopic Colon Resection - Anterior ApproachGeorge S. Ferzli
 
Transanal total mesorectal excision
Transanal total mesorectal excisionTransanal total mesorectal excision
Transanal total mesorectal excisionAbhishek Thakur
 
Bowel prep - Dr. Somaya Banaei
Bowel prep - Dr. Somaya BanaeiBowel prep - Dr. Somaya Banaei
Bowel prep - Dr. Somaya BanaeiSomaya Banaei
 
TEP
TEPTEP
TEPGeorge S. Ferzli
 
Satyajeet Carcinoma Stomach management
Satyajeet Carcinoma Stomach management Satyajeet Carcinoma Stomach management
Satyajeet Carcinoma Stomach management Satyajeet Rath
 
Esophagectomy : APPROACHES, CONTROVERSIES AND CURRENT EVIDENCE
Esophagectomy : APPROACHES, CONTROVERSIES AND CURRENT EVIDENCEEsophagectomy : APPROACHES, CONTROVERSIES AND CURRENT EVIDENCE
Esophagectomy : APPROACHES, CONTROVERSIES AND CURRENT EVIDENCEDr Amit Dangi
 
Surgery for Rectal Cancer
Surgery for Rectal CancerSurgery for Rectal Cancer
Surgery for Rectal Cancerensteve
 
Duodeno Pancreatic Injuries - Evaluation and Assessment.pptx
Duodeno Pancreatic Injuries - Evaluation and Assessment.pptxDuodeno Pancreatic Injuries - Evaluation and Assessment.pptx
Duodeno Pancreatic Injuries - Evaluation and Assessment.pptxDr Debmoy Ghatak
 
Minimal invasive Surgery in Management of colorectal cancer
Minimal invasive Surgery in Management of colorectal cancerMinimal invasive Surgery in Management of colorectal cancer
Minimal invasive Surgery in Management of colorectal cancerpiyushpatwa
 
Carcinoma oesophagus
Carcinoma oesophagusCarcinoma oesophagus
Carcinoma oesophagusDr Rajinder Dhaliwal
 
Trans Hiatal Esophagectomy
Trans Hiatal EsophagectomyTrans Hiatal Esophagectomy
Trans Hiatal EsophagectomyKurdGEHS
 

More Related Content

What's hot

Laparoscopic Herniorrhaphy: TEP
Laparoscopic Herniorrhaphy: TEPLaparoscopic Herniorrhaphy: TEP
Laparoscopic Herniorrhaphy: TEPGeorge S. Ferzli
 
Ivor lewis esophagectomy
Ivor lewis esophagectomyIvor lewis esophagectomy
Ivor lewis esophagectomyrajat1906
 
Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface Malignancies
Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface MalignanciesHyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface Malignancies
Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface MalignanciesMary Ondinee Manalo Igot
 
Crs+hipec— jeddah,
Crs+hipec— jeddah,Crs+hipec— jeddah,
Crs+hipec— jeddah,Basalama Ali
 
Component separation for ventral hernias prof. ahm shamsul alam
Component separation for ventral hernias prof. ahm shamsul alamComponent separation for ventral hernias prof. ahm shamsul alam
Component separation for ventral hernias prof. ahm shamsul alamnoel alam
 
LAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptx
LAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptxLAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptx
LAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptxSelvaraj Balasubramani
 
Intestinal transplant
Intestinal transplantIntestinal transplant
Intestinal transplantMahesh Raj
 
Component separation technique for a very large abdominal wall hernia
Component separation technique for a very large abdominal wall herniaComponent separation technique for a very large abdominal wall hernia
Component separation technique for a very large abdominal wall herniaSanjiv Haribhakti
 
Laparoscopic Colon Resection - Anterior Approach
Laparoscopic Colon Resection - Anterior ApproachLaparoscopic Colon Resection - Anterior Approach
Laparoscopic Colon Resection - Anterior ApproachGeorge S. Ferzli
 
Transanal total mesorectal excision
Transanal total mesorectal excisionTransanal total mesorectal excision
Transanal total mesorectal excisionAbhishek Thakur
 
Bowel prep - Dr. Somaya Banaei
Bowel prep - Dr. Somaya BanaeiBowel prep - Dr. Somaya Banaei
Bowel prep - Dr. Somaya BanaeiSomaya Banaei
 
Satyajeet Carcinoma Stomach management
Satyajeet Carcinoma Stomach management Satyajeet Carcinoma Stomach management
Satyajeet Carcinoma Stomach management Satyajeet Rath
 
Esophagectomy : APPROACHES, CONTROVERSIES AND CURRENT EVIDENCE
Esophagectomy : APPROACHES, CONTROVERSIES AND CURRENT EVIDENCEEsophagectomy : APPROACHES, CONTROVERSIES AND CURRENT EVIDENCE
Esophagectomy : APPROACHES, CONTROVERSIES AND CURRENT EVIDENCEDr Amit Dangi
 
Surgery for Rectal Cancer
Surgery for Rectal CancerSurgery for Rectal Cancer
Surgery for Rectal Cancerensteve
 
Duodeno Pancreatic Injuries - Evaluation and Assessment.pptx
Duodeno Pancreatic Injuries - Evaluation and Assessment.pptxDuodeno Pancreatic Injuries - Evaluation and Assessment.pptx
Duodeno Pancreatic Injuries - Evaluation and Assessment.pptxDr Debmoy Ghatak
 
Minimal invasive Surgery in Management of colorectal cancer
Minimal invasive Surgery in Management of colorectal cancerMinimal invasive Surgery in Management of colorectal cancer
Minimal invasive Surgery in Management of colorectal cancerpiyushpatwa
 

What's hot (20)

Laparoscopic Herniorrhaphy: TEP
Laparoscopic Herniorrhaphy: TEPLaparoscopic Herniorrhaphy: TEP
Laparoscopic Herniorrhaphy: TEP
 
Ivor lewis esophagectomy
Ivor lewis esophagectomyIvor lewis esophagectomy
Ivor lewis esophagectomy
 
Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface Malignancies
Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface MalignanciesHyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface Malignancies
Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Surface Malignancies
 
Stents in surgery
Stents in surgeryStents in surgery
Stents in surgery
 
Damage Control Surgery
Damage Control SurgeryDamage Control Surgery
Damage Control Surgery
 
Crs+hipec— jeddah,
Crs+hipec— jeddah,Crs+hipec— jeddah,
Crs+hipec— jeddah,
 
Component separation for ventral hernias prof. ahm shamsul alam
Component separation for ventral hernias prof. ahm shamsul alamComponent separation for ventral hernias prof. ahm shamsul alam
Component separation for ventral hernias prof. ahm shamsul alam
 
LAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptx
LAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptxLAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptx
LAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptx
 
Intestinal transplant
Intestinal transplantIntestinal transplant
Intestinal transplant
 
Component separation technique for a very large abdominal wall hernia
Component separation technique for a very large abdominal wall herniaComponent separation technique for a very large abdominal wall hernia
Component separation technique for a very large abdominal wall hernia
 
Intestinal anastomosis and staplers
Intestinal anastomosis and staplersIntestinal anastomosis and staplers
Intestinal anastomosis and staplers
 
Laparoscopic Colon Resection - Anterior Approach
Laparoscopic Colon Resection - Anterior ApproachLaparoscopic Colon Resection - Anterior Approach
Laparoscopic Colon Resection - Anterior Approach
 
Transanal total mesorectal excision
Transanal total mesorectal excisionTransanal total mesorectal excision
Transanal total mesorectal excision
 
Bowel prep - Dr. Somaya Banaei
Bowel prep - Dr. Somaya BanaeiBowel prep - Dr. Somaya Banaei
Bowel prep - Dr. Somaya Banaei
 
TEP
TEPTEP
TEP
 
Satyajeet Carcinoma Stomach management
Satyajeet Carcinoma Stomach management Satyajeet Carcinoma Stomach management
Satyajeet Carcinoma Stomach management
 
Esophagectomy : APPROACHES, CONTROVERSIES AND CURRENT EVIDENCE
Esophagectomy : APPROACHES, CONTROVERSIES AND CURRENT EVIDENCEEsophagectomy : APPROACHES, CONTROVERSIES AND CURRENT EVIDENCE
Esophagectomy : APPROACHES, CONTROVERSIES AND CURRENT EVIDENCE
 
Surgery for Rectal Cancer
Surgery for Rectal CancerSurgery for Rectal Cancer
Surgery for Rectal Cancer
 
Duodeno Pancreatic Injuries - Evaluation and Assessment.pptx
Duodeno Pancreatic Injuries - Evaluation and Assessment.pptxDuodeno Pancreatic Injuries - Evaluation and Assessment.pptx
Duodeno Pancreatic Injuries - Evaluation and Assessment.pptx
 
Minimal invasive Surgery in Management of colorectal cancer
Minimal invasive Surgery in Management of colorectal cancerMinimal invasive Surgery in Management of colorectal cancer
Minimal invasive Surgery in Management of colorectal cancer
 

Viewers also liked

Trans Hiatal Esophagectomy
Trans Hiatal EsophagectomyTrans Hiatal Esophagectomy
Trans Hiatal EsophagectomyKurdGEHS
 
Endoscopic Palliation of Esophageal Cancer
Endoscopic Palliation of Esophageal CancerEndoscopic Palliation of Esophageal Cancer
Endoscopic Palliation of Esophageal CancerOSUCCC - James
 
Leakage after oesophagectomy
Leakage after oesophagectomyLeakage after oesophagectomy
Leakage after oesophagectomyforegutsurgeon
 
Dr Pradeep Jain Fortis Hospital - Thoraco Laparoscopic Esophagectomy
Dr Pradeep Jain Fortis Hospital - Thoraco Laparoscopic EsophagectomyDr Pradeep Jain Fortis Hospital - Thoraco Laparoscopic Esophagectomy
Dr Pradeep Jain Fortis Hospital - Thoraco Laparoscopic EsophagectomyDr Pradeep Jain Reviews
 
Esophaegeal resection & reconstruction
Esophaegeal resection & reconstructionEsophaegeal resection & reconstruction
Esophaegeal resection & reconstructionSaeed Al-Shomimi
 
Minimally Invasive Esophagectomy
Minimally Invasive EsophagectomyMinimally Invasive Esophagectomy
Minimally Invasive Esophagectomyguest87d35b
 
Laparoscopic Ivor Lewis Esophagectomy
Laparoscopic Ivor Lewis EsophagectomyLaparoscopic Ivor Lewis Esophagectomy
Laparoscopic Ivor Lewis EsophagectomyPradeep Jain
 
Endoscopy in Gastrointestinal Oncology - Slide 5 - R. Rosati - Esophageal can...
Endoscopy in Gastrointestinal Oncology - Slide 5 - R. Rosati - Esophageal can...Endoscopy in Gastrointestinal Oncology - Slide 5 - R. Rosati - Esophageal can...
Endoscopy in Gastrointestinal Oncology - Slide 5 - R. Rosati - Esophageal can...European School of Oncology
 
Laparoscopic gastrectomies for cancer
Laparoscopic gastrectomies for cancerLaparoscopic gastrectomies for cancer
Laparoscopic gastrectomies for cancerEduardo Guzman
 
Git Esophageal Cancer.
Git Esophageal Cancer.Git Esophageal Cancer.
Git Esophageal Cancer.Shaikhani.
 
Esophageal cancer
Esophageal cancerEsophageal cancer
Esophageal cancerAhmed Allam
 
The surgical management of gastroesophageal cancer
The surgical management of gastroesophageal cancerThe surgical management of gastroesophageal cancer
The surgical management of gastroesophageal cancerforegutsurgeon
 

Viewers also liked (20)

Carcinoma oesophagus
Carcinoma oesophagusCarcinoma oesophagus
Carcinoma oesophagus
 
Trans Hiatal Esophagectomy
Trans Hiatal EsophagectomyTrans Hiatal Esophagectomy
Trans Hiatal Esophagectomy
 
Endoscopic Palliation of Esophageal Cancer
Endoscopic Palliation of Esophageal CancerEndoscopic Palliation of Esophageal Cancer
Endoscopic Palliation of Esophageal Cancer
 
Leakage after oesophagectomy
Leakage after oesophagectomyLeakage after oesophagectomy
Leakage after oesophagectomy
 
Dr Pradeep Jain Fortis Hospital - Thoraco Laparoscopic Esophagectomy
Dr Pradeep Jain Fortis Hospital - Thoraco Laparoscopic EsophagectomyDr Pradeep Jain Fortis Hospital - Thoraco Laparoscopic Esophagectomy
Dr Pradeep Jain Fortis Hospital - Thoraco Laparoscopic Esophagectomy
 
Kshivets milan2014
Kshivets milan2014Kshivets milan2014
Kshivets milan2014
 
Esophaegeal resection & reconstruction
Esophaegeal resection & reconstructionEsophaegeal resection & reconstruction
Esophaegeal resection & reconstruction
 
Gerd, gastritis
Gerd, gastritisGerd, gastritis
Gerd, gastritis
 
Minimally Invasive Esophagectomy
Minimally Invasive EsophagectomyMinimally Invasive Esophagectomy
Minimally Invasive Esophagectomy
 
Carcinoma of esophagus n
Carcinoma of esophagus nCarcinoma of esophagus n
Carcinoma of esophagus n
 
Laparoscopic Ivor Lewis Esophagectomy
Laparoscopic Ivor Lewis EsophagectomyLaparoscopic Ivor Lewis Esophagectomy
Laparoscopic Ivor Lewis Esophagectomy
 
Endoscopy in Gastrointestinal Oncology - Slide 5 - R. Rosati - Esophageal can...
Endoscopy in Gastrointestinal Oncology - Slide 5 - R. Rosati - Esophageal can...Endoscopy in Gastrointestinal Oncology - Slide 5 - R. Rosati - Esophageal can...
Endoscopy in Gastrointestinal Oncology - Slide 5 - R. Rosati - Esophageal can...
 
Laparoscopic gastrectomies for cancer
Laparoscopic gastrectomies for cancerLaparoscopic gastrectomies for cancer
Laparoscopic gastrectomies for cancer
 
Git Esophageal Cancer.
Git Esophageal Cancer.Git Esophageal Cancer.
Git Esophageal Cancer.
 
Esophageal cancer
Esophageal cancerEsophageal cancer
Esophageal cancer
 
Esophageal cancer
Esophageal cancerEsophageal cancer
Esophageal cancer
 
The surgical management of gastroesophageal cancer
The surgical management of gastroesophageal cancerThe surgical management of gastroesophageal cancer
The surgical management of gastroesophageal cancer
 
Pancreatic Carcinoma
Pancreatic CarcinomaPancreatic Carcinoma
Pancreatic Carcinoma
 
Carcinoma esophagus
Carcinoma esophagusCarcinoma esophagus
Carcinoma esophagus
 
mediastinum
mediastinummediastinum
mediastinum
 

Similar to Laparoscopic trans hiatal esophagectomy for early cancer-final

Esophageal adenocarcinoma p t1 sages
Esophageal adenocarcinoma p t1 sagesEsophageal adenocarcinoma p t1 sages
Esophageal adenocarcinoma p t1 sagesforegutsurgeon
 
Early ca esophagus
Early ca esophagusEarly ca esophagus
Early ca esophagusRajiv paul
 
Gastric cancer management
Gastric cancer managementGastric cancer management
Gastric cancer managementNabeel Yahiya
 
Nuclear medicine in gastroenterology
Nuclear medicine in gastroenterologyNuclear medicine in gastroenterology
Nuclear medicine in gastroenterologyLokender Yadav
 
ECCLU 2011 - H. Van Poppel - Prostate cancer: Managing of pelvic nodes - Surg...
ECCLU 2011 - H. Van Poppel - Prostate cancer: Managing of pelvic nodes - Surg...ECCLU 2011 - H. Van Poppel - Prostate cancer: Managing of pelvic nodes - Surg...
ECCLU 2011 - H. Van Poppel - Prostate cancer: Managing of pelvic nodes - Surg...European School of Oncology
 
Carcinoma Colon And Management
Carcinoma Colon And ManagementCarcinoma Colon And Management
Carcinoma Colon And ManagementPGIMER, AIIMS
 
Radiotherapy for bladder cancers
Radiotherapy for bladder cancersRadiotherapy for bladder cancers
Radiotherapy for bladder cancersAshutosh Mukherji
 
MON 2011 - Slide 20 - P. Rougier - Gastric and pancreatic cancers (part I)
MON 2011 - Slide 20 - P. Rougier - Gastric and pancreatic cancers (part I)MON 2011 - Slide 20 - P. Rougier - Gastric and pancreatic cancers (part I)
MON 2011 - Slide 20 - P. Rougier - Gastric and pancreatic cancers (part I)European School of Oncology
 
MCO 2011 - Slide 22 - P. Rougier - Gastric and pancreatic cancers (part I)
MCO 2011 - Slide 22 - P. Rougier - Gastric and pancreatic cancers (part I)MCO 2011 - Slide 22 - P. Rougier - Gastric and pancreatic cancers (part I)
MCO 2011 - Slide 22 - P. Rougier - Gastric and pancreatic cancers (part I)European School of Oncology
 
Evidence based Surgical Management of Esophageal and Gastric Cancer
Evidence based Surgical Management of Esophageal and Gastric CancerEvidence based Surgical Management of Esophageal and Gastric Cancer
Evidence based Surgical Management of Esophageal and Gastric CancerPradeep Dhanasekaran
 
Cancergastri2008
Cancergastri2008Cancergastri2008
Cancergastri2008Deep Deep
 
Metastatic liver disease (2)
Metastatic liver disease (2)Metastatic liver disease (2)
Metastatic liver disease (2)mostafa hegazy
 
Renal Cancers Rationale
Renal Cancers RationaleRenal Cancers Rationale
Renal Cancers Rationalefondas vakalis
 
Renal Cancers Rationale
Renal Cancers RationaleRenal Cancers Rationale
Renal Cancers Rationalefondas vakalis
 
Treatment of Cancer of the Esophagus
Treatment of Cancer of the EsophagusTreatment of Cancer of the Esophagus
Treatment of Cancer of the EsophagusRobert J Miller MD
 
Lo stent nelle occlusioni neoplastiche del Colon - Gastrolearning®
Lo stent nelle occlusioni neoplastiche del Colon - Gastrolearning®Lo stent nelle occlusioni neoplastiche del Colon - Gastrolearning®
Lo stent nelle occlusioni neoplastiche del Colon - Gastrolearning®Gastrolearning
 

Similar to Laparoscopic trans hiatal esophagectomy for early cancer-final (20)

Esophageal adenocarcinoma p t1 sages
Esophageal adenocarcinoma p t1 sagesEsophageal adenocarcinoma p t1 sages
Esophageal adenocarcinoma p t1 sages
 
Early ca esophagus
Early ca esophagusEarly ca esophagus
Early ca esophagus
 
Ca stomach
Ca stomachCa stomach
Ca stomach
 
Ca esophagus
Ca esophagusCa esophagus
Ca esophagus
 
Gastric cancer management
Gastric cancer managementGastric cancer management
Gastric cancer management
 
Nuclear medicine in gastroenterology
Nuclear medicine in gastroenterologyNuclear medicine in gastroenterology
Nuclear medicine in gastroenterology
 
ECCLU 2011 - H. Van Poppel - Prostate cancer: Managing of pelvic nodes - Surg...
ECCLU 2011 - H. Van Poppel - Prostate cancer: Managing of pelvic nodes - Surg...ECCLU 2011 - H. Van Poppel - Prostate cancer: Managing of pelvic nodes - Surg...
ECCLU 2011 - H. Van Poppel - Prostate cancer: Managing of pelvic nodes - Surg...
 
18
1818
18
 
Carcinoma Colon And Management
Carcinoma Colon And ManagementCarcinoma Colon And Management
Carcinoma Colon And Management
 
Radiotherapy for bladder cancers
Radiotherapy for bladder cancersRadiotherapy for bladder cancers
Radiotherapy for bladder cancers
 
MON 2011 - Slide 20 - P. Rougier - Gastric and pancreatic cancers (part I)
MON 2011 - Slide 20 - P. Rougier - Gastric and pancreatic cancers (part I)MON 2011 - Slide 20 - P. Rougier - Gastric and pancreatic cancers (part I)
MON 2011 - Slide 20 - P. Rougier - Gastric and pancreatic cancers (part I)
 
MCO 2011 - Slide 22 - P. Rougier - Gastric and pancreatic cancers (part I)
MCO 2011 - Slide 22 - P. Rougier - Gastric and pancreatic cancers (part I)MCO 2011 - Slide 22 - P. Rougier - Gastric and pancreatic cancers (part I)
MCO 2011 - Slide 22 - P. Rougier - Gastric and pancreatic cancers (part I)
 
Evidence based Surgical Management of Esophageal and Gastric Cancer
Evidence based Surgical Management of Esophageal and Gastric CancerEvidence based Surgical Management of Esophageal and Gastric Cancer
Evidence based Surgical Management of Esophageal and Gastric Cancer
 
Cancergastri2008
Cancergastri2008Cancergastri2008
Cancergastri2008
 
Carcinoma esophagus 2020
Carcinoma esophagus 2020Carcinoma esophagus 2020
Carcinoma esophagus 2020
 
Metastatic liver disease (2)
Metastatic liver disease (2)Metastatic liver disease (2)
Metastatic liver disease (2)
 
Renal Cancers Rationale
Renal Cancers RationaleRenal Cancers Rationale
Renal Cancers Rationale
 
Renal Cancers Rationale
Renal Cancers RationaleRenal Cancers Rationale
Renal Cancers Rationale
 
Treatment of Cancer of the Esophagus
Treatment of Cancer of the EsophagusTreatment of Cancer of the Esophagus
Treatment of Cancer of the Esophagus
 
Lo stent nelle occlusioni neoplastiche del Colon - Gastrolearning®
Lo stent nelle occlusioni neoplastiche del Colon - Gastrolearning®Lo stent nelle occlusioni neoplastiche del Colon - Gastrolearning®
Lo stent nelle occlusioni neoplastiche del Colon - Gastrolearning®
 

More from foregutsurgeon

Rationale for Bariatric surgery: Medical & Financial Arguments
Rationale for Bariatric surgery: Medical & Financial ArgumentsRationale for Bariatric surgery: Medical & Financial Arguments
Rationale for Bariatric surgery: Medical & Financial Argumentsforegutsurgeon
 
Gastric Electrical Stimulation for Gastroparesis
Gastric Electrical Stimulation for GastroparesisGastric Electrical Stimulation for Gastroparesis
Gastric Electrical Stimulation for Gastroparesisforegutsurgeon
 
Surgery is Better than Medical Management for Non-Alcoholic Fatty Liver Disease
Surgery is Better than Medical Management for Non-Alcoholic Fatty Liver DiseaseSurgery is Better than Medical Management for Non-Alcoholic Fatty Liver Disease
Surgery is Better than Medical Management for Non-Alcoholic Fatty Liver Diseaseforegutsurgeon
 
Weight loss surgery safe & effective
Weight loss surgery safe & effectiveWeight loss surgery safe & effective
Weight loss surgery safe & effectiveforegutsurgeon
 
Weight loss surgery overview
Weight loss surgery overviewWeight loss surgery overview
Weight loss surgery overviewforegutsurgeon
 
Stomach pacemaker for weight loss
Stomach pacemaker for weight lossStomach pacemaker for weight loss
Stomach pacemaker for weight lossforegutsurgeon
 
The future of bariatric surgery
The future of bariatric surgeryThe future of bariatric surgery
The future of bariatric surgeryforegutsurgeon
 
Long term outcomes of the laparoscopic sleeve gastrectomy
Long term outcomes of the laparoscopic sleeve gastrectomyLong term outcomes of the laparoscopic sleeve gastrectomy
Long term outcomes of the laparoscopic sleeve gastrectomyforegutsurgeon
 
Incisionless procedures and stomach pacemaker for obesity
Incisionless procedures and stomach pacemaker for obesityIncisionless procedures and stomach pacemaker for obesity
Incisionless procedures and stomach pacemaker for obesityforegutsurgeon
 
Emergencies after bariatric surgery
Emergencies after bariatric surgeryEmergencies after bariatric surgery
Emergencies after bariatric surgeryforegutsurgeon
 
History of bariatric surgery
History of bariatric surgeryHistory of bariatric surgery
History of bariatric surgeryforegutsurgeon
 
Non cardiac chest pain
Non cardiac chest painNon cardiac chest pain
Non cardiac chest painforegutsurgeon
 
Laparoscopic groin hernia repair anatomy & technique
Laparoscopic groin hernia repair anatomy & techniqueLaparoscopic groin hernia repair anatomy & technique
Laparoscopic groin hernia repair anatomy & techniqueforegutsurgeon
 
Laparoscopy for gastric cancer
Laparoscopy for gastric cancerLaparoscopy for gastric cancer
Laparoscopy for gastric cancerforegutsurgeon
 
Laparoscopic surgery for small bowel tumours
Laparoscopic surgery for small bowel tumoursLaparoscopic surgery for small bowel tumours
Laparoscopic surgery for small bowel tumoursforegutsurgeon
 

More from foregutsurgeon (20)

Rationale for Bariatric surgery: Medical & Financial Arguments
Rationale for Bariatric surgery: Medical & Financial ArgumentsRationale for Bariatric surgery: Medical & Financial Arguments
Rationale for Bariatric surgery: Medical & Financial Arguments
 
Gastric Electrical Stimulation for Gastroparesis
Gastric Electrical Stimulation for GastroparesisGastric Electrical Stimulation for Gastroparesis
Gastric Electrical Stimulation for Gastroparesis
 
Surgery is Better than Medical Management for Non-Alcoholic Fatty Liver Disease
Surgery is Better than Medical Management for Non-Alcoholic Fatty Liver DiseaseSurgery is Better than Medical Management for Non-Alcoholic Fatty Liver Disease
Surgery is Better than Medical Management for Non-Alcoholic Fatty Liver Disease
 
Weight loss surgery safe & effective
Weight loss surgery safe & effectiveWeight loss surgery safe & effective
Weight loss surgery safe & effective
 
Weight loss surgery overview
Weight loss surgery overviewWeight loss surgery overview
Weight loss surgery overview
 
Stomach pacemaker for weight loss
Stomach pacemaker for weight lossStomach pacemaker for weight loss
Stomach pacemaker for weight loss
 
The future of bariatric surgery
The future of bariatric surgeryThe future of bariatric surgery
The future of bariatric surgery
 
Metabolic surgery
Metabolic surgeryMetabolic surgery
Metabolic surgery
 
Long term outcomes of the laparoscopic sleeve gastrectomy
Long term outcomes of the laparoscopic sleeve gastrectomyLong term outcomes of the laparoscopic sleeve gastrectomy
Long term outcomes of the laparoscopic sleeve gastrectomy
 
Incisionless procedures and stomach pacemaker for obesity
Incisionless procedures and stomach pacemaker for obesityIncisionless procedures and stomach pacemaker for obesity
Incisionless procedures and stomach pacemaker for obesity
 
Sop for rygb
Sop for rygbSop for rygb
Sop for rygb
 
Emergencies after bariatric surgery
Emergencies after bariatric surgeryEmergencies after bariatric surgery
Emergencies after bariatric surgery
 
History of bariatric surgery
History of bariatric surgeryHistory of bariatric surgery
History of bariatric surgery
 
Anti reflux surgery
Anti reflux surgeryAnti reflux surgery
Anti reflux surgery
 
Non cardiac chest pain
Non cardiac chest painNon cardiac chest pain
Non cardiac chest pain
 
Laparoscopic groin hernia repair anatomy & technique
Laparoscopic groin hernia repair anatomy & techniqueLaparoscopic groin hernia repair anatomy & technique
Laparoscopic groin hernia repair anatomy & technique
 
Groin hernia repair
Groin hernia repairGroin hernia repair
Groin hernia repair
 
Gastroparesis
GastroparesisGastroparesis
Gastroparesis
 
Laparoscopy for gastric cancer
Laparoscopy for gastric cancerLaparoscopy for gastric cancer
Laparoscopy for gastric cancer
 
Laparoscopic surgery for small bowel tumours
Laparoscopic surgery for small bowel tumoursLaparoscopic surgery for small bowel tumours
Laparoscopic surgery for small bowel tumours
 

Recently uploaded

Aspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliAspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliRewAs ALI
 
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000aliya bhat
 
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...narwatsonia7
 
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableVip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableNehru place Escorts
 
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service JaipurHigh Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipurparulsinha
 
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service LucknowCall Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknownarwatsonia7
 
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...Garima Khatri
 
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Call Girl Coimbatore Prisha☎️ 8250192130 Independent Escort Service Coimbatore
Call Girl Coimbatore Prisha☎️ 8250192130 Independent Escort Service CoimbatoreCall Girl Coimbatore Prisha☎️ 8250192130 Independent Escort Service Coimbatore
Call Girl Coimbatore Prisha☎️ 8250192130 Independent Escort Service Coimbatorenarwatsonia7
 
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original PhotosCall Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photosnarwatsonia7
 
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...Miss joya
 
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...Miss joya
 
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...narwatsonia7
 
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort ServiceCollege Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort ServiceNehru place Escorts
 
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service MumbaiVIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbaisonalikaur4
 
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls ServiceCall Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Servicesonalikaur4
 
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...narwatsonia7
 
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service MumbaiLow Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbaisonalikaur4
 

Recently uploaded (20)

Aspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas AliAspirin presentation slides by Dr. Rewas Ali
Aspirin presentation slides by Dr. Rewas Ali
 
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hsr Layout Just Call 7001305949 Top Class Call Girl Service Available
 
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
Ahmedabad Call Girls CG Road 🔝9907093804 Short 1500 💋 Night 6000
 
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
 
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls AvailableVip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
Vip Call Girls Anna Salai Chennai 👉 8250192130 ❣️💯 Top Class Girls Available
 
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service JaipurHigh Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
High Profile Call Girls Jaipur Vani 8445551418 Independent Escort Service Jaipur
 
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service LucknowCall Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
 
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
 
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
 
Call Girl Coimbatore Prisha☎️ 8250192130 Independent Escort Service Coimbatore
Call Girl Coimbatore Prisha☎️ 8250192130 Independent Escort Service CoimbatoreCall Girl Coimbatore Prisha☎️ 8250192130 Independent Escort Service Coimbatore
Call Girl Coimbatore Prisha☎️ 8250192130 Independent Escort Service Coimbatore
 
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original PhotosCall Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
 
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCREscort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
 
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
 
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
College Call Girls Pune Mira 9907093804 Short 1500 Night 6000 Best call girls...
 
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Kanakapura Road Just Call 7001305949 Top Class Call Girl Service A...
 
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort ServiceCollege Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
College Call Girls Vyasarpadi Whatsapp 7001305949 Independent Escort Service
 
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service MumbaiVIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
VIP Call Girls Mumbai Arpita 9910780858 Independent Escort Service Mumbai
 
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls ServiceCall Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
 
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
Call Girls Electronic City Just Call 7001305949 Top Class Call Girl Service A...
 
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service MumbaiLow Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
Low Rate Call Girls Mumbai Suman 9910780858 Independent Escort Service Mumbai
 

Laparoscopic trans hiatal esophagectomy for early cancer-final

  • 1. Laparoscopic Trans-Hiatal Esophagectomy for Early Cancer Abeezar I. Sarela Department of Upper GI & Minimally Invasive Surgery Leeds, UK
  • 2. SAGES Presenter Disclosure Slide Abeezar I. Sarela Nothing To Disclose
  • 3.
  • 4. What is Early Esophageal Cancer? Superficial Esophageal Carcinoma Japanese Esophageal Society Esophagus 2009;6:1-25 T1a + T1b AJCC/TNM 7 th Edition Early Esophageal Carcinoma Japanese Esophageal Society Esophagus 2009;6:1-25 T1a AJCC/TNM 7th Edition
  • 5.
  • 6. Subclassification of Depth of Invasion by Superficial Carcinoma of the Esophagus in Surgically Resected Specimens Endoscopic Resection Specimens sm1 carcinoma: invades less than 200 microns into the submucosa Japanese Esophageal Society. Japanese Classification of Esophageal Cancer. !0 th Ed. Esophagus 2009;6:1-25
  • 7. Relationship between Depth of Invasion and Lymph Node Metastasis in Superficial Squamous Carcinoma Takubo et al. Histopathology 2007;51:733-742
  • 8.
  • 9. Oncological Outcomes Esophagectomy for pT1 Adenocarcinoma Saha et al. Surg Endosc 2009;23:119-124 40 patients - T1b 11 patients - N1 20% of T1b - Poor differentiation 4 patients Liver 22 N0 Poor T1a Trans-thoracic Liver 8 N1 Poor T1b Trans-thoracic Nodes 6 N0 Poor T1b Trans-Hiatal Site of recurrence Time to recurrence Node status Differentiation Tumor Depth Operation
  • 10. Diagnosis and Staging of Early (T1a) and Superficial (T1a+T1b) Esophageal Carcinoma
  • 11. Endoscopic Diagnosis of Early Esophageal Carcinoma Fujinon “FICE” Olympus “Tri-Modality”
  • 12. Can we predict the risk of lymph node metastasis? 27% 50% 20% 10% 10% Incidence of nodal metastasis Takubo et al. Histopathology 2007;51:733-742
  • 13.
  • 14.
  • 15.
  • 16. Emerging Treatment Paradigm EMR of all resectable dysplastic lesions Favourable histology? Multifocality? Ablation of the remaining Barrett‘s - ?RFA Endoscopic Surveillance
  • 17.
  • 18.
  • 19.
  • 20. Laparoscopic Esophagectomy Transhiatal vs. Transthoracic Decker et al. European Journal of Cardio-Thoracic Surgery. 2009;35:13-21 17 (7-62) 10 (5-15) Lymph node count 2.4% 4.6% Mortality 6.8% 3% Re-operation 22% 22% Respiratory complic. 7.6% 13% Leakage 6.4% 10% Vocal cord palsy Transthoracic 1499 patients Transhiatal 433 patients
  • 21.
  • 22.
  • 23.
  • 24.  
  • 25.