Difference between revisions of "Transhiatal esophagectomy"
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Nirav Kamdar (talk | contribs) |
Nirav Kamdar (talk | contribs) (updated procedure variants and maintenance of anesthesia.) |
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* Supine with both arms tucked | * Supine with both arms tucked | ||
=== Maintenance and surgical considerations | === Maintenance and surgical considerations === | ||
===== Abdominal laparoscopy: ===== | |||
===== Gastric anastamosis: ===== | |||
===== Esophageal transection: ===== | |||
===== Gastric pull-through: ===== | |||
===== Anastamosis: ===== | |||
=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> === | === Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> === | ||
| Line 93: | Line 103: | ||
{| class="wikitable" | {| class="wikitable" | ||
|+ | |+ | ||
* Very few series have been published comparing robotic and laparoscopic approach. | |||
! | ! | ||
!Laparoscopic | !Laparoscopic | ||
| Line 102: | Line 113: | ||
|- | |- | ||
|Position | |Position | ||
| | |Supine | ||
| | |Supine; arms tucked | ||
|- | |- | ||
|Surgical time | |Surgical time | ||
| | |279min<ref name=":0">{{Cite journal|last=Seto|first=Yasuyuki|last2=Mori|first2=Kazuhiko|last3=Aikou|first3=Susumu|date=2017-09|title=Robotic surgery for esophageal cancer: Merits and demerits|url=https://pubmed.ncbi.nlm.nih.gov/29863149|journal=Annals of Gastroenterological Surgery|volume=1|issue=3|pages=193–198|doi=10.1002/ags3.12028|issn=2475-0328|pmc=5881348|pmid=29863149}}</ref> | ||
| | |267-311min | ||
|- | |- | ||
|EBL | |EBL | ||
| | |88mL<ref name=":0" /> | ||
| | |54-100mL | ||
|- | |- | ||
|Postoperative disposition | |Postoperative disposition | ||
| Line 119: | Line 130: | ||
|Pain management | |Pain management | ||
| | | | ||
| | |Epidural | ||
|- | |- | ||
|Potential complications | |Potential complications | ||
| | | | ||
| | |Pulmonary | ||
Anastamotic leak (9-33%) | |||
Vocal cord palsy (5-30%) | |||
|- | |||
|Length of Stay | |||
|9.2 days<ref name=":0" /> | |||
|9-10 days | |||
|} | |} | ||
Revision as of 11:17, 17 June 2021
Transhiatal esophagectomy
| Anesthesia type |
General |
|---|---|
| Airway |
8-O ETT |
| Lines and access |
Large bore PIV Arterial Line NG-tube |
| Monitors |
Standard Arterial Line |
| Primary anesthetic considerations | |
| Preoperative | |
| Intraoperative | |
| Postoperative |
Anastamotic leak |
| Article quality | |
| Editor rating | |
| User likes | 0 |
Provide a brief summary of this surgical procedure and its indications here.
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Neurologic | |
| Cardiovascular | |
| Respiratory | |
| Gastrointestinal | |
| Hematologic | |
| Renal | |
| Endocrine | |
| Other |
Labs and studies
Operating room setup
- 8-O ETT for periemergence bronchoscopy
- Arterial line
- Large bore peripheral IV
- NG tube to decompress stomach
Patient preparation and premedication
- EKG leads on back of shoulders to facilitate neck prep
Regional and neuraxial techniques
- Epidural for post-operative pain control
Intraoperative management
Monitoring and access
- Standard ASA Monitors
- Arterial line
Induction and airway management
Positioning
- Supine with both arms tucked
Maintenance and surgical considerations
Abdominal laparoscopy:
Gastric anastamosis:
Esophageal transection:
Gastric pull-through:
Anastamosis:
Emergence
Postoperative management
Disposition
Pain management
Potential complications
Procedure variants
| Laparoscopic | Robotic | |
|---|---|---|
| Unique considerations | ||
| Position | Supine | Supine; arms tucked |
| Surgical time | 279min[1] | 267-311min |
| EBL | 88mL[1] | 54-100mL |
| Postoperative disposition | ||
| Pain management | Epidural | |
| Potential complications | Pulmonary
Anastamotic leak (9-33%) Vocal cord palsy (5-30%) | |
| Length of Stay | 9.2 days[1] | 9-10 days |
References
Top contributors: Nirav Kamdar, Elmar Malek and Chris Rishel