Articles

Thoracoscopic Esophagectomy in Prone Position: A Cross-Sectional Study

Abstract

Surgical resection with curative intent is still a central therapeutic option for resectable esophageal cancer. Thoracoscopicesophagectomy in a prone position would give each benefit of the lateral position. The present research aimed to analyze the short-term outcomes of thoracoscopicesophagectomy in the prone position. This was a retrospective cross-sectional study. Patients who underwent thoracoscopicesophagectomy in the prone position at Tehran University Cancer institute from January 2017 to December 2018 entered the study. The esophagus was mobilized through the thoracoscopic approach in a prone position. The stomach was released using a laparoscopic approach for the gastric pull-up. Finally, an end-to-end hand-sewn cervical anastomosis was performed. Three, four, seven, one, and one patient suffered from pneumonia, leakage, tracheal tearing, chylothorax, and pneumothorax, respectively, after the operation. In 91.5% of patients, more than ten lymph nodes were resected. Sixty percent of patients were discharged from the hospital earlier than one week. Laparoscopicesophagectomy in the prone position is a feasible alternative. Better exposure and fewer complications were reported.

1. Swanstrom LL, Hansen P. Laparoscopic total esophagectomy. Arch Surg 1997:132:943-9.
2. Bailey SH, Bull DA, Harpole DH, Rentz JJ, Neumayer LA, et al. Outcomes after esophagectomy: a ten-year prospective cohort. Ann ThoracSurg 2003;75:217-22.
3. Luketich JD, Alvelo-Rivera M, Buenaventura PO, Christie NA, McCaughan JS, Litle VR, et al. Minimally invasive esophagectomy: outcomes in 222 patients. Ann Surg 2003:238:486-94.
4. Nguyen NT, Follette DM, Wolfe BM, Schneider PD, Roberts P, Goodnight JE Jr. Comparison of minimally invasive esophagectomy with transthoracic and transhiatalesophagectomy. Arch Surg 2000:135:920-5.
5. Torek F. The first successful case of resection of the thoracic portion of the esophagus for carcinoma. Surg Gynecol Obstet 1913:16:614-7.
6. Torek F. Carcinoma of the thoracic portion of the esophagus: report of a case in which operation was done eleven years ago. Arch Surg 1925:10:353-60.
7. Takeuchi H, Miyata H, Gotoh M, Kitagawa Y, Baba H, Kimura W, et al. A risk model for esophagectomy using data of 5354 patients included in a Japanese nationwide web-based database. Ann Surg 2014;260:259-66.
8. Markar S, Gronnier C, Duhamel A, Bigourdan JM, Badic B, du Rieu MC, et al. Pattern of postoperative mortality after esophageal cancer resection according to center volume: results from a large European multicenter study. Ann SurgOncol 2015:22:2615-2623.
9. Palanivelu C, Prakash A, Senthilkumar R, Senthilnathan P, Parthasarathi R, Rajan PS, et al. Minimally invasive esophagectomy: thoracoscopic mobilization of the esophagus and mediastinal lymphadenectomy in prone position--experience of 130 patients. J Am CollSurg 2006:203:7-16.
10. Smithers B, Gotley D, McEwan D, Martin I, Bessell J, Doyle L. Thoracoscopic mobilization of the esophagus. SurgEndosc 2001:15:176-82.
11. Yatabe T, Kitagawa H, Yamashita K, Akimori T, Hanazaki K, Yokoyama M. Better postoperative oxygenation in thoracoscopicesophagectomy in prone positioning. J Anesth 2010:24:803-6.
12. Smithers BM, Gotley DC, Martin I, Thomas JM Comparison of the outcomes between open and minimally invasive esophagectomy. Ann Surg 2007:245:232-40.
13. Pinto CE, Dias JA, Sá EAM, Tsunoda AT, Pinheiro RN. Tratamentocirúrgico do câncer de esôfago. Rev Bras Cancerol 2007:53:425-30.
14. Feng M, Shen Y, Wang H, Tan L, Zhang Y, Khan MA, et al. Thoracolaparoscopicesophagectomy: is the prone position a safe alternative to the decubitus position? J Am CollSurg 2012:214:838-44.
15. Fabian T, McKelvey A, Kent M, Federico JA. Prone thoracoscopic esophageal mobilization for minimally invasive esophagectomy. SurgEndosc 2007:21:1667-70.
16. Gossot D, Fourquier P, Celerier M Thoracoscopicesophagectomy: technique and initial results. Ann ThoracSurg 1993:56:667-70.
17. Cuschieri A, Shimi S, Banting S Endoscopic oesophagectomy through a right thoracoscopic approach. J R CollSurgsEdinb 1992:37:7-11.
18. DePaula AL, Hashiba K, Ferreira E, Grecco E Laparoscopic transhiatalesophagectomy with esophagogastroplasty. SurgLaparoscEndosc 1995:5:1-5.
Files
IssueVol 59, No 7 (2021) QRcode
SectionArticles
Published2021-08-25
DOI https://doi.org/10.18502/acta.v59i7.7025
Keywords
Thoracoscopy Esophagectomy Prone position

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Miri SR, Khalaj A, Jafarlou V, Khoshdani Farahani P, Bahramian A. Thoracoscopic Esophagectomy in Prone Position: A Cross-Sectional Study. Acta Med Iran. 2021;59(7):442-446.