Early postoperative rehabilitation (fast track) after laparo-thoracoscopic re-section of the proximal stomach and thoracic esophagus about cardioesophageal cancer

An obstacle to the use of minimally invasive video-endoscopic approaches for radical surgical operations for cardioesophageal cancer is the need of resection and lymphadenectomy in the two anatomical areas. The resolution of the problem of injuries surgical accesses actualizes the problem of optimal postoperative management of these patients. In 2015-16, we performed 27 resection of the proximal stomach and lower esophagus with one-stage intrapleural esophagogastroplasty a combined laparoscopic and right thoracoscopic access. Prevailed patients in III stage of disease - 9 14 (51,9 %) patients. In 4 cases ( 14,8%) cases were identified with stage IV. R0 resection was performed in 24 (88,9%) patients, R1 - 3 (11,1 %). Histological examination was studied on average 42±3 lymph node. The advantages of radical operations for cardioesophageal cancer a combined laparoscopic and right thoracoscopic approaches: the clarity of the visualization, good control of hemostasis, ease of mobilization of the stomach and esophagus, early activation of patients in the postoperative period (4 days), reduced length of hospital stay (7.3 days). The use of early rehabilitation after surgery technology (ERAS or “fast-track”) allows to reduce the duration of hospitalization, accelerate recovery and rehabilitation of patients.