Comparison of the short-term outcomes of patients with esophageal cancer after subtotal esophagectomy via thoracoscopy in left lateral position and in prone position

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Author:
HOU Yu-long(Department of Cardiothoracic Surgery,Huai'an First Hospital, Nanjing Medical University, Jiangsu Huai'an 223300, China)
ZHAO Jian-qiang(Department of Cardiothoracic Surgery,Huai'an First Hospital, Nanjing Medical University, Jiangsu Huai'an 223300, China)
GUO Wei(Department of Cardiothoracic Surgery,Huai'an First Hospital, Nanjing Medical University, Jiangsu Huai'an 223300, China)
ZANG Bao(Department of Cardiothoracic Surgery,Huai'an First Hospital, Nanjing Medical University, Jiangsu Huai'an 223300, China)
TANG De-rong(Department of Cardiothoracic Surgery,Huai'an First Hospital, Nanjing Medical University, Jiangsu Huai'an 223300, China)
Journal Title:
Chinese Journal of Gastrointestinal Surgery
Issue:
Volume 15, Issue 09, 2012
DOI:
10.3760/cma.j.issn.1671-0274.2012.09.021
Key Word:
Esophageal neoplasms; Thoracolaparoscopic esophagectomy; Esophagectomy;Prone position

Abstract: Objective To compare the short-term outcomes in patients with esophageal cancer after subtotal esophagectomy via thoracoscopy in prone position and in left lateral position.Methods Between September 2008 and September 2010,thoracolaparoscopic esophagectomy (TLE) with thoracoscopic mobilization of the esophagus and mediastinal esophagectomy was performed in 41 patients in prone position (group A) and other 41 patients (group B) performed bv the same surgeon in left lateral position.Results Preoperatively,the endoscopic location of the tumor was in the upper third in 5 cases(2 vs.3),the middle third in 21 cases(12 vs.9),and the lower third in 56 cases(27 vs.29).The median operative time was 230 (range 170-310) min in group A and 280(range 190-380) min in group B (P=0.04).The median intraoperative blood loss was 275 (range 100-320) ml in group A and 360 (range 120-670) ml in group B (P=0.09).The median number of lymph nodes dissected was 8.4 (range 4-23) in group A and 6.9 (range 6-21 ) in group B (P=0.03).The postoperative complications totaled 6(14.6%) in group A and 8(17.1%) in group B(P=0.44).After a median follow-up period of 15.7(range 2-28) months for group A and 16.3(range 3-31 ) months for group B,19 patients in group A died and 21 patients in group B.Conclusions For esophageal cancer under T3N1M0,surgical outcomes are similar between prone thoracoscopic esophageal mobilization and left lateral position.Prone position may be associated with better lymph node dissection.

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