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Lewis Santi under laparoscopy

  • Admission the day before surgery
  • No bowel preparation required
  • Operating time 4 hours
  • Right-side abdominal and thoracic double access
  • Resumption of oral diet at 7 days with blen-ded foods
  • Length of hospital stay 10 days on average
In France, the incidence of oesophageal cancer is 2000/year. The main predisposing fac-tors are acid reflux, alcohol and tobacco. There are two main types of cancer: squamous cell carcinoma (more common among men) and adenocarcinoma (better prognosis: 42% chance of survival at 5 years, versus 30% for the squamous cell carcinoma). The main warning signs are difficulty to swallow solid foods and significant weight loss. The tests to be carried out quickly are:

- Oesophagogastroduodenoscopy, carried out by your gastroenterologist
- Thoracoabdominopelvic CT scan with injection in a radiology center.

The goal of the surgery is to remove the tumour in its entirety to limit the risk of relapse. The surgical technique (Lewis Santi) involves a double approach to remove the tumour (ab-dominal + thoracic laparoscopy) and then reconstructing a "neo-oesophagus" with part of the stomach that will ascend in the posterior mediastinum. The main complications following this type of operation are :

- Lung infection
- Heart or thromboembolic problems
- Fistulas

For small tumours of the oesophagus, curative surgery will be suggested from the outset, whereas in case of locally advanced tumours, radiotherapy and chemotherapy will initially be recommended to facilitate a surgical procedure at a later time.