Pavanello M

Videothoracoscopic enucleation of esophageal leiomyoma

A new thoracoscopic technique to enucleate esophageal leiomyomas is described. The procedure has been successfully performed in 3 patients. All patients benefited by this new surgical approach due to the decreased operative trauma, reduced postoperative pain, quick recovery, and minute skin scars. Although further clinical experience and longer periods of follow-up are needed to evaluate the full benefits and limits of this new access, the early results of the thoracoscopic approach are promising.

Temporary double exclusion of the perforated esophagus using absorbable staples

A new method for double exclusion of the esophagus is presented. Temporary closure of the cervical and intraabdominal esophagus using absorbable staples allows effective healing of esophageal perforations. The procedure should be routinely combined with drainage of the periesophageal abscess. Complete recanalization of the esophagus occurs 1 to 2 weeks after operation.

Cancer of the Thoracic Esophagus: What Is an Adequate Lymphadenectomy?

The extent of lymph node dissection in esophageal cancer is a topic of continuing clinical investigation and debate. Conflicting results, both in terms of postoperative complications and long-term survival, are reported in the literature. Preliminary results suggest that a more accurate surgical staging, and consequently a more realistic long-term prognosis, is provided by extended lymphadenectomy. Extended lymph node dissection seems to be prognostically rewarding at least in selected carcinomas of the upper and mid thoracic esophagus, which are resectable for cure.