Transcervical Endoscopic Esophageal Mobilization: An Approach to Transhiatal Esophagectomy

• Published in: Annals of thoracic surgery short reports 2024-09
• Main Authors: Livschitz, Jennifer, Melamed, Joshua, Donato, Britton, Lee, Amy Yoonjin, Dong, Huaying, Szabo, Aniko, Tisol, William B., Linsky, Paul L., Gasparri, Mario G., Johnstone, David W.
• Format: Article
• Language: English
• ISSN: 2772-9931; 2772-9931
• DOI: 10.1016/j.atssr.2024.09.011

Transcervical endoscopic esophageal mobilization (TEEM) is an approach to transhiatal esophagectomy that aims to minimize blood loss and decrease the operative time commonly associated with traditional transhiatal technique. A retrospective chart review was conducted on patients who underwent TEEM esophagectomy between 2009 and 2020. Baseline characteristics, perioperative outcomes, and postoperative complications were recorded. To report survival, a Kaplan-Meier survival plot was developed using SAS software (SAS Institute). A total of 241 patients underwent TEEM esophagectomy. The mean operative time was 185.1 ± 59.3 minutes, blood loss was 251.4 ± 212.3 mL, the number lymph nodes dissected was 13.6 ± 6.2, and the length of stay was 11.9 ± 8.5 days. In the postoperative setting, 68 (28.2%) patients experienced hoarseness, 62 (25.7%) had postoperative atrial fibrillation, 30 (12.4%) had an anastomotic leak, and 12 (4.6%) experienced chylothorax. The overall 30- and 90-day mortality rates were 2.1% (5 of 241) and 4.6% (11 of 241), respectively. The median overall survival was 2.36 years, with 60% 3-year survival and 40% 5-year survival. TEEM esophagectomy is a safe approach with acceptable postoperative morbidity and mortality and shorter operative times compared with historical norms.