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Langenbeck's Archives of Surgery

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01-08-2018 | ORIGINAL ARTICLE

Comparison of perioperative and oncological outcome of thoracoscopic esophagectomy in left decubitus position and in prone position for esophageal cancer

Authors: Shirou Kuwabara, Kazuaki Kobayashi, Akira Kubota, Ikuma Shioi, Kenji Yamaguchi, Norio Katayanagi

Published in: Langenbeck's Archives of Surgery | Issue 5/2018

Abstract

Purpose

The aim of this study was to clarify the differences between thoracoscopic esophagectomy in the left decubitus position (LP) and in the prone position (PP) in terms of short-term perioperative outcomes and long-term oncological outcomes after more than 5 years of follow-up.

Methods

Patients with esophageal cancer who underwent thoracoscopic esophagectomy and were followed up for more than 5 years were analyzed retrospectively. Of 142 patients, 72 underwent LP esophagectomy and 70 underwent PP esophagectomy. Operation time, blood loss, operative morbidity, mortality, length of hospital stay, and the number of dissected lymph nodes were compared to evaluate short-term outcomes. Cancer recurrence and overall survival were compared to examine long-term outcomes.

Results

Patient and tumor characteristics were not different between the LP and PP groups except for the rate of neoadjuvant chemotherapy. Blood loss was significantly lower in the PP group than in the LP group. Incidence of Clavien-Dindo (C.D.) grade ≥ III complications was significantly lower in the PP group than in the LP group. Pulmonary complications were also significantly lower in the PP group than in the LP group. Operation type (LP versus PP) was identified as an independent risk factor for pulmonary complications (odds ratio 0.27, p = 0.03) by multivariate analysis. Cancer recurrence rate, initial recurrence site, and overall survival rate were not different between the two groups.

Conclusions

PP is regarded as a less invasive procedure than LP with the same oncological effect.

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Title: Comparison of perioperative and oncological outcome of thoracoscopic esophagectomy in left decubitus position and in prone position for esophageal cancer
Authors: Shirou Kuwabara
Kazuaki Kobayashi
Akira Kubota
Ikuma Shioi
Kenji Yamaguchi
Norio Katayanagi
Publication date: 01-08-2018
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 5/2018
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-018-1674-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Comparison of perioperative and oncological outcome of thoracoscopic esophagectomy in left decubitus position and in prone position for esophageal cancer

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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