Top

Published in:

01-08-2016 | ORIGINAL ARTICLE

Outcomes of thoracoscopic esophagectomy in prone position with laparoscopic gastric mobilization for esophageal cancer

Published in: Langenbeck's Archives of Surgery | Issue 5/2016

Abstract

Purpose

The aim of this study was to evaluate the short- and long-term outcomes of thoracoscopic esophagectomy performed in the prone position (TSE-PP) followed by laparoscopic gastric mobilization (LGM) compared with open thoracotomy and LGM, for esophageal cancers.

Methods

We reviewed the records of 105 consecutive patients who underwent esophagectomy with LGM for esophageal cancer at Kochi Medical School. Among the study patients, 60 patients underwent TSE-PP, while 45 underwent open thoracotomy (OPEN group). The perioperative outcomes of the two groups were compared.

Results

Compared to the OPEN group, the TSE-PP group had lower blood loss (TSE-PP, 150 mL; OPEN, 430 mL; P < 0.001), longer operative time (TSE-PP, 609 min; OPEN, 570 min; P = 0.012), more lymph nodes dissected around the left recurrent laryngeal nerve (TSE-PP, 6; OPEN, 2; P < 0.001), and a shorter length of hospital stay (TSE-PP, 16.5 days; OPEN, 35 days; P < 0.001). The incidence of postoperative complications was similar in the two groups. Though the recurrence rate and overall survival were not significantly different in the two groups, the TSE-PP group had better overall survival rates than the OPEN group (P = 0.122).

Conclusions

Patients who underwent TSE-PP with LGM for esophageal cancers recovered earlier after surgery compared to those who underwent open thoracotomy with LGM.

Lerut T, Nafteux P, Moons J et al (2004) Three-field lymphadenectomy for carcinoma of the esophagus and gastroesophageal junction in 174 R0 resections: impact on staging, disease-free survival, and outcome: a plea for adaptation of TNM classification in upper-half esophageal carcinoma. Ann Surg 240:962–972CrossRefPubMedPubMedCentral

Fujita H, Kakegawa T, Yamana H et al (1995) Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer. Comparison of three-field lymphadenectomy with two-field lymphadenectomy. Ann Surg 222:654–662CrossRefPubMedPubMedCentral

Osugi H, Takemura M, Higashino M et al (2003) A comparison of video-assisted thoracoscopic oesophagectomy and radical lymph node dissection for squamous cell cancer of the oesophagus with open operation. Br J Surg 90:108–113CrossRefPubMed

Luketich JD, Alvelo-Rivera M, Buenaventura PO et al (2003) Minimally invasive esophagectomy: outcomes in 222 patients. Ann Surg 238:486–494PubMedPubMedCentral

Kitagawa H, Namikawa T, Iwabu J et al (2013) Efficacy of laparoscopic gastric mobilization for esophagectomy: comparison with open thoraco-abdominal approach. J Laparoendosc Adv Surg Tech A 23:452–455CrossRefPubMed

Kitagawa H, Akimori T, Okabayashi T et al (2009) Total laparoscopic gastric mobilization for esophagectomy. Langenbecks Arch Surg 394:617–621CrossRefPubMed

Palanivelu C, Prakash A, Senthilkumar R et al (2006) Minimally invasive esophagectomy: thoracoscopic mobilization of the esophagus and mediastinal lymphadenectomy in prone position—experience of 130 patients. J Am Coll Surg 203:7–16CrossRefPubMed

Fabian T, Martin J, Katigbak M et al (2008) Thoracoscopic esophageal mobilization during minimally invasive esophagectomy: a head-to-head comparison of prone versus decubitus positions. Surg Endosc 22:2485–2491CrossRefPubMed

Nozaki I, Kato K, Igaki H et al (2015) Evaluation of safety profile of thoracoscopic esophagectomy for T1bN0M0 cancer using data from JCOG0502: a prospective multicenter study. Surg Endosc 29:3519–3526CrossRefPubMedPubMedCentral

10.

Noshiro H, Miyake S (2013) Thoracoscopic esophagectomy using prone positioning. Ann Thorac Cardiovasc Surg 19:399–408CrossRefPubMed

11.

Noshiro H, Iwasaki H, Kobayashi K et al (2010) Lymphadenectomy along the left recurrent laryngeal nerve by a minimally invasive esophagectomy in the prone position for thoracic esophageal cancer. Surg Endosc 24:2965–2973CrossRefPubMed

12.

Kaburagi T, Takeuchi H, Kawakubo H et al (2014) Clinical utility of a novel hybrid position combining the left lateral decubitus and prone positions during thoracoscopic esophagectomy. World J Surg 38:410–418CrossRefPubMed

13.

Garas G, Kayani B, Tolley N et al (2013) Is there a role for intraoperative recurrent laryngeal nerve monitoring during high mediastinal lymph node dissection in three-stage oesophagectomy for oesophageal cancer? Int J Surg 11:370–373CrossRefPubMed

14.

Osugi H, Takemura M, Higashino M et al (2003) Learning curve of video-assisted thoracoscopic esophagectomy and extensive lymphadenectomy for squamous cell cancer of the thoracic esophagus and results. Surg Endosc 17:515–519CrossRefPubMed

15.

Ninomiya I, Osugi H, Fujimura T et al (2008) Results of video-assisted thoracoscopic surgery for esophageal cancer during the induction period. Gen Thorac Cardiovasc Surg 56:119–125CrossRefPubMed

16.

Meng F, Li Y, Ma H et al (2014) Comparison of outcomes of open and minimally invasive esophagectomy in 183 patients with cancer. J Thorac Dis 6:1218–1224PubMedPubMedCentral

17.

Yatabe T, Kitagawa H, Yamashita K et al (2013) Comparison of the perioperative outcome of esophagectomy by thoracoscopy in the prone position with that of thoracotomy in the lateral decubitus position. Surg Today 43:386–391CrossRefPubMed

18.

Smithers BM, Gotley DC, Martin I et al (2007) Comparison of the outcomes between open and minimally invasive esophagectomy. Ann Surg 245:232–240CrossRefPubMedPubMedCentral

19.

Feng M, Shen Y, Wang H et al (2012) Thoracolaparoscopic esophagectomy: is the prone position a safe alternative to the decubitus position? J Am Coll Surg 214:838–844CrossRefPubMed

20.

Biere SS, van Berge Henegouwen MI, Maas KW et al (2012) Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet 379:1887–1892CrossRefPubMed

21.

Kubo N, Ohira M, Yamashita Y et al (2014) The impact of combined thoracoscopic and laparoscopic surgery on pulmonary complications after radical esophagectomy in patients with resectably esophageal cancer. Anticancer Res 34:2399–2404PubMed

22.

Briez N, Piessen G, Bonnetain F et al (2011) Open versus laparoscopically-assisted oesophagectomy for cancer: a multicentre randomised controlled phase III trial - the MIRO trial. BMC Cancer 11:310CrossRefPubMedPubMedCentral

23.

Oshikiri T, Yasuda T, Kawasaki K et al (2016) Hand-assisted laparoscopic surgery (HALS) is associated with less-restrictive ventilatory impairment and less risk for pulmonary complication than open laparotomy in thoracoscopic esophagectomy. Surgery 159:459–466CrossRefPubMed

24.

Kitagawa H, Namikawa T, Munekage M et al (2015) Visualization of the stomach’s arterial networks during esophageal surgery using the Hypereye Medical System. Anticancer Res 35:6201–6205PubMed

25.

Ninomiya I, Okamoto K, Fujimura T et al (2014) Oncologic outcomes of thoracoscopic esophagectomy with extended lymph node dissection: 10-year experience from a single center. World J Surg 38:120–130CrossRefPubMed

26.

Thomson IG, Smithers BM, Gotley DC et al (2010) Thoracoscopic-assisted esophagectomy for esophageal cancer: analysis of patterns and prognostic factors for recurrence. Ann Surg 252:281–291CrossRefPubMed

27.

Ando N, Kato H, Igaki H et al (2012) A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol 19:68–74CrossRefPubMed

Title: Outcomes of thoracoscopic esophagectomy in prone position with laparoscopic gastric mobilization for esophageal cancer
Publication date: 01-08-2016
Published in: Langenbeck's Archives of Surgery / Issue 5/2016
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-016-1446-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Outcomes of thoracoscopic esophagectomy in prone position with laparoscopic gastric mobilization for esophageal cancer

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2016

Effects of mesenchymal stem cells and VEGF on liver regeneration following major resection

Proximal gastrectomy versus total gastrectomy for proximal third gastric cancer: total gastrectomy is not always necessary

Robotic liver surgery for minor hepatic resections: a comparison with laparoscopic and open standard procedures

German national guideline on the management of pilonidal disease

Appendiceal stump closure using polymeric clips reduces intra-abdominal abscesses

Cholangitis in the postoperative course after biliodigestive anastomosis