Transcervical Endoscopic Esophageal Mobilization: An Approach to Transhiatal Esophagectomy

Background: 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. Methods: A retrospective chart review was conducted on patients...

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Main Authors: Jennifer Livschitz, MD, MS, Joshua Melamed, MD, Britton Donato, MD, Amy Yoonjin Lee, MD, Huaying Dong, BS, Aniko Szabo, PhD, William B. Tisol, MD, Paul L. Linsky, MD, Mario G. Gasparri, MD, David W. Johnstone, MD
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Annals of Thoracic Surgery Short Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S2772993124003723
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author Jennifer Livschitz, MD, MS
Joshua Melamed, MD
Britton Donato, MD
Amy Yoonjin Lee, MD
Huaying Dong, BS
Aniko Szabo, PhD
William B. Tisol, MD
Paul L. Linsky, MD
Mario G. Gasparri, MD
David W. Johnstone, MD
author_facet Jennifer Livschitz, MD, MS
Joshua Melamed, MD
Britton Donato, MD
Amy Yoonjin Lee, MD
Huaying Dong, BS
Aniko Szabo, PhD
William B. Tisol, MD
Paul L. Linsky, MD
Mario G. Gasparri, MD
David W. Johnstone, MD
author_sort Jennifer Livschitz, MD, MS
collection DOAJ
description Background: 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. Methods: 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). Results: 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. Conclusions: TEEM esophagectomy is a safe approach with acceptable postoperative morbidity and mortality and shorter operative times compared with historical norms.
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spelling doaj-art-28634db21af447edb2a44f0080d9db262025-08-20T02:11:12ZengElsevierAnnals of Thoracic Surgery Short Reports2772-99312025-03-013120120510.1016/j.atssr.2024.09.011Transcervical Endoscopic Esophageal Mobilization: An Approach to Transhiatal EsophagectomyJennifer Livschitz, MD, MS0Joshua Melamed, MD1Britton Donato, MD2Amy Yoonjin Lee, MD3Huaying Dong, BS4Aniko Szabo, PhD5William B. Tisol, MD6Paul L. Linsky, MD7Mario G. Gasparri, MD8David W. Johnstone, MD9Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin; Address correspondence to Dr Livschitz, Division of Cardiothoracic Surgery, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53266.Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WisconsinDivision of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WisconsinDivision of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WisconsinDepartment of Biostatistics, Beth Israel Deaconess Medical Center, Boston, MassachusettsDepartment of Biostatistics, Medical College of Wisconsin, Milwaukee, WisconsinDepartment of Surgery, Advocate Aurora Health, Milwaukee, WisconsinDivision of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WisconsinDivision of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WisconsinDivision of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WisconsinBackground: 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. Methods: 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). Results: 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. Conclusions: TEEM esophagectomy is a safe approach with acceptable postoperative morbidity and mortality and shorter operative times compared with historical norms.http://www.sciencedirect.com/science/article/pii/S2772993124003723
spellingShingle Jennifer Livschitz, MD, MS
Joshua Melamed, MD
Britton Donato, MD
Amy Yoonjin Lee, MD
Huaying Dong, BS
Aniko Szabo, PhD
William B. Tisol, MD
Paul L. Linsky, MD
Mario G. Gasparri, MD
David W. Johnstone, MD
Transcervical Endoscopic Esophageal Mobilization: An Approach to Transhiatal Esophagectomy
Annals of Thoracic Surgery Short Reports
title Transcervical Endoscopic Esophageal Mobilization: An Approach to Transhiatal Esophagectomy
title_full Transcervical Endoscopic Esophageal Mobilization: An Approach to Transhiatal Esophagectomy
title_fullStr Transcervical Endoscopic Esophageal Mobilization: An Approach to Transhiatal Esophagectomy
title_full_unstemmed Transcervical Endoscopic Esophageal Mobilization: An Approach to Transhiatal Esophagectomy
title_short Transcervical Endoscopic Esophageal Mobilization: An Approach to Transhiatal Esophagectomy
title_sort transcervical endoscopic esophageal mobilization an approach to transhiatal esophagectomy
url http://www.sciencedirect.com/science/article/pii/S2772993124003723
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