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Published in:

01-03-2017

Prone position in thoracoscopic esophagectomy improves postoperative oxygenation and reduces pulmonary complications

Authors: Dai Otsubo, Tetsu Nakamura, Masashi Yamamoto, Shingo Kanaji, Kiyonori Kanemitsu, Kimihiro Yamashita, Tatsuya Imanishi, Taro Oshikiri, Yasuo Sumi, Satoshi Suzuki, Daisuke Kuroda, Yoshihiro Kakeji

Published in: Surgical Endoscopy | Issue 3/2017

Abstract

Background

While thoracoscopic esophagectomy is a widely performed surgical procedure, only few studies regarding the influence of body position on changes in circulation and breathing, after the surgery, have been reported. This study aimed at evaluating the effect of body position, during surgery, on the postoperative breathing functions of the chest.

Methods

A total of 266 patients who underwent right-sided transthoracic esophagectomy for esophageal cancer from 2004 to 2012 were included in this study. Fifty-four of them underwent open thoracotomies in the left lateral decubitus position (Group O), 108 underwent thoracoscopic esophagectomy in the left lateral decubitus position (Group L) and 104 patients were treated by thoracoscopic esophagectomy in the prone position (Group P). Two patients in Group P, who presented with intra-operative bleeding and underwent thoracotomy, were subsequently excluded from the pulmonary function analysis.

Results

Two patients in Group P had to be changed from the prone position to the lateral decubitus position and underwent thoracotomy in order to control intra-operative bleeding. Despite the significantly longer chest operation period in Group P, total blood loss was significantly lower in this group when compared to Groups O and L. Furthermore, patients in Group P presented with significantly lower water balance during the perioperative period and markedly higher SpO₂/FiO₂ ratio after the surgery. The incidence of respiratory complications was significantly higher in Group O when compared to the other two groups; however, no significant differences were observed between the Groups L and P.

Conclusion

The findings of this study demonstrate that thoracoscopic esophagectomy in the prone position improves postoperative oxygenation and is therefore a potentially superior surgical approach.

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Title: Prone position in thoracoscopic esophagectomy improves postoperative oxygenation and reduces pulmonary complications
Authors: Dai Otsubo
Tetsu Nakamura
Masashi Yamamoto
Shingo Kanaji
Kiyonori Kanemitsu
Kimihiro Yamashita
Tatsuya Imanishi
Taro Oshikiri
Yasuo Sumi
Satoshi Suzuki
Daisuke Kuroda
Yoshihiro Kakeji
Publication date: 01-03-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 3/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-016-5081-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prone position in thoracoscopic esophagectomy improves postoperative oxygenation and reduces pulmonary complications

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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