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01-10-2019 | Esophagus Resection | Thoracic Oncology

Long-Term Outcomes of Thoracoscopic Esophagectomy in the Prone versus Lateral Position: A Propensity Score-Matched Analysis

Authors: Susumu Miura, MD, Tetsu Nakamura, PhD, MD, Yukiko Miura, MD, Gosuke Takiguchi, PhD, MD, Nobuhisa Takase, PhD, MD, Hiroshi Hasegawa, PhD, MD, Masashi Yamamoto, PhD, MD, Shingo Kanaji, PhD, MD, Yoshiko Matsuda, PhD, MD, Kimihiro Yamashita, PhD, MD, Takeru Matsuda, PhD, MD, Taro Oshikiri, PhD, MD, Satoshi Suzuki, PhD, MD, Yoshihiro Kakeji, PhD, MD

Published in: Annals of Surgical Oncology | Issue 11/2019

Abstract

Background

Several studies have suggested that thoracoscopic esophagectomy (TE) in the prone position (TEP) may be more feasible than TE in the lateral position (TEL); however, few studies have compared long-term survival between the two procedures. We evaluated whether TEP is oncologically equivalent to TEL.

Methods

Surgical outcomes of TEs performed from January 2006 to December 2013 at our hospital were retrospectively analyzed. Propensity score matching was used to control for confounding factors.

Results

TE was performed in 200 patients diagnosed with esophageal squamous cell carcinoma; 78 patients were matched in two procedures. The mean thoracic operative time in TEL was shorter than in TEP (228.9 min vs. 299.1 min; p < 0.001); however, the mean thoracic blood loss in TEL was higher than in TEP (186.9 ml vs. 76.5 ml; p < 0.001). The mean number of thoracic lymph nodes harvested in TEL was lower than in TEP (23.5 vs. 26.9; p < 0.05), and the pulmonary complication rate in TEL was higher than in TEP (30.8% vs. 15.4%; p < 0.05). The 5-year overall survival rates in pathological stage I (81.2% vs. 81.6%; p = 0.82), stage II (65.3% vs. 80.9%; p = 0.21), stage III (26.7% vs. 24.2%; p = 0.86) and all stages (63.6% vs. 62.3%; p = 0.88), and the 5-year progression-free survival rates in pathological stage I (78.0% vs. 81.8%; p = 0.54), stage II (53.5% vs. 77.6%; p = 0.13), stage III (10.5% vs. 12.8%; p = 0.81) and all stages (53.6% vs. 57.9%; p = 0.50) were not significantly different between the two procedures.

Conclusion

TEP and TEL provide equal oncological efficiency.

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Title: Long-Term Outcomes of Thoracoscopic Esophagectomy in the Prone versus Lateral Position: A Propensity Score-Matched Analysis
Authors: Susumu Miura, MD
Tetsu Nakamura, PhD, MD
Yukiko Miura, MD
Gosuke Takiguchi, PhD, MD
Nobuhisa Takase, PhD, MD
Hiroshi Hasegawa, PhD, MD
Masashi Yamamoto, PhD, MD
Shingo Kanaji, PhD, MD
Yoshiko Matsuda, PhD, MD
Kimihiro Yamashita, PhD, MD
Takeru Matsuda, PhD, MD
Taro Oshikiri, PhD, MD
Satoshi Suzuki, PhD, MD
Yoshihiro Kakeji, PhD, MD
Publication date: 01-10-2019
Publisher: Springer International Publishing
Keywords: Esophagus Resection
Esophagus Resection
Published in: Annals of Surgical Oncology / Issue 11/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-019-07619-x

At a glance: The STEP trials

Springer Medicine

Long-Term Outcomes of Thoracoscopic Esophagectomy in the Prone versus Lateral Position: A Propensity Score-Matched Analysis

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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