The surgical treatment of established esophageal corrosive injury involves the replacement of scarred esophagus with either gastric or colonic conduit. Routinely, this has been performed by open surgical method, which leads to unpleasant long laparotomy scars and its associated consequences. Owing to the relatively young age of the affected population and the need to minimize the morbidity associated with laparotomy and thoracotomy, minimally invasive surgery began to be preferred over the more traditional open technique. In addition to providing the benefit of a long-lasting, one-time therapy, it also produced good cosmetic outcomes while restoring oro-enteral continuity and re-establishing euphagia. The safety and feasibility of minimally invasive laparoscopic and robot-assisted operations have been documented. The intraoperative benefits include decreased blood loss and dissection under vision which translates to reduce morbidity and better short-term outcomes. Short-term benefits in the immediate postoperative period include reduced postoperative pain and analgesic requirements, early ambulation, a shorter hospital stay, and better cosmesis. The medium- and long-term outcomes are comparable to open surgery, with majority of patients being euphagic and having no laparotomy-related problems, such as incisional hernia. This chapter discusses the numerous minimally invasive surgical methods, indications, procedural steps, benefits, and limitations that are available to the operating surgeon.

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Minimal Access Surgery in Corrosive Esophageal Injury

  • Senthil Gnanasekaran,
  • Satish Durgesh

摘要

The surgical treatment of established esophageal corrosive injury involves the replacement of scarred esophagus with either gastric or colonic conduit. Routinely, this has been performed by open surgical method, which leads to unpleasant long laparotomy scars and its associated consequences. Owing to the relatively young age of the affected population and the need to minimize the morbidity associated with laparotomy and thoracotomy, minimally invasive surgery began to be preferred over the more traditional open technique. In addition to providing the benefit of a long-lasting, one-time therapy, it also produced good cosmetic outcomes while restoring oro-enteral continuity and re-establishing euphagia. The safety and feasibility of minimally invasive laparoscopic and robot-assisted operations have been documented. The intraoperative benefits include decreased blood loss and dissection under vision which translates to reduce morbidity and better short-term outcomes. Short-term benefits in the immediate postoperative period include reduced postoperative pain and analgesic requirements, early ambulation, a shorter hospital stay, and better cosmesis. The medium- and long-term outcomes are comparable to open surgery, with majority of patients being euphagic and having no laparotomy-related problems, such as incisional hernia. This chapter discusses the numerous minimally invasive surgical methods, indications, procedural steps, benefits, and limitations that are available to the operating surgeon.