Comparison of short-term outcomes between prone and lateral decubitus positions for thoracoscopic esophagectomy

• Published in: Surgical endoscopy Vol. 29; no. 9; pp. 2756 - 2762
• Main Authors: Teshima, Jin, Miyata, Go, Kamei, Takashi, Nakano, Toru, Abe, Shigeo, Katsura, Kazunori, Taniyama, Yusuke, Sakurai, Tadashi, Hikage, Makoto, Nakamura, Takanobu, Takaya, Kai, Zuguchi, Masashi, Okamoto, Hiroshi, Youhei, Ozawa, Ohuchi, Noriaki
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.09.2015; Springer Nature B.V
• Subjects: Abdominal Surgery; Adult; Aged; Blood Loss, Surgical - statistics & numerical data; Cancer therapies; Epidural; Esophageal cancer; Esophageal Neoplasms - surgery; Esophagectomy - methods; Feasibility Studies; Female; Gastroenterology; Gynecology; Hepatology; Hospital Mortality; Hospitals; Humans; Intensive care; Length of Stay - statistics & numerical data; Lymph Node Excision - methods; Lymphatic system; Male; Medicine; Medicine & Public Health; Middle Aged; Mortality; Oncology; Operative Time; Ostomy; Patient Positioning - methods; Postoperative Complications - etiology; Postoperative Period; Proctology; Prone Position; Radiation; Retrospective Studies; Surgery; Surgical outcomes; Thoracoscopy - methods; Tomography; Japan; GI; Surgical; Technical; Thoracoscopy; Cancer
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-014-4003-y

Background Prone thoracoscopic esophagectomy was introduced at our institution from 2012. This study describes our experiences of the main differences between thoracoscopic esophagectomy in the prone and traditional left lateral decubitus positions together with an analysis of the short-term surgical outcomes. Method In total, 87 patients undergoing thoracoscopic esophagectomy between January 2012 and October 2013 at Tohoku University Hospital were enrolled; of these, 54 and 33 patients were operated in the prone (Group P) and lateral decubitus (Group L) positions, respectively. Results The background of the patients was similar, and there was no in-hospital mortality. There were no significant differences between the groups in terms of whole surgical duration, thoracic duration, and number of dissected lymph nodes. Total blood loss and thoracic estimated blood loss were significantly lower in Group P than Group L. Furthermore, postoperative pulmonary complications, intensive care unit stay, and hospital stay were significantly lower in Group P. Conclusion Thoracoscopic esophagectomy in the prone position is feasible and safe. The prone position technique may be superior to conventional lateral decubitus position esophagectomy.