Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Research article

Thoracoscopic and hand assisted laparoscopic esophagectomy with radical lymph node dissection for esophageal squamous cell carcinoma in the left lateral decubitus position: a single center retrospective analysis of 654 patients

Authors: Masahiko Murakami, Koji Otsuka, Satoru Goto, Tomotake Ariyoshi, Takeshi Yamashita, Takeshi Aoki

Published in: BMC Cancer | Issue 1/2017

Login to get access

Abstract

Background

The rates of thoracoscopic esophagectomy performed in the prone and left lateral decubitus positions are similar in Japan. We retrospectively reviewed short- and long-term outcomes of thoracoscopic esophagectomy for esophageal cancer performed in the left lateral decubitus position.

Methods

Between 1996 and 2015, 654 patients with esophageal cancer underwent thoracoscopic esophagectomy in the left lateral decubitus position. Patients were divided into early (1996–2008) and late groups (2009–2015, with standardization of the procedure and formalized training), and their clinical outcomes reviewed.

Results

The completion rate of thoracoscopic esophagectomy was 99.5%, and the procedure was converted to thoracotomy in three patients, due to hemorrhage. The mean intrathoracic operative time, intrathoracic blood loss, and number of dissected mediastinal lymph nodes were 205.0 min, 127.3 mL, and 24.7, respectively. Postoperative complications included pneumonia (8.5%), anastomotic leakage (7.5%), and recurrent nerve paralysis (3.5%). Postoperative (30d) mortality was 4/654 (0.61%) due to anastomotic leak and pneumonia. The five year overall survival rate was 70%. A comparison of the 289 early- and 365 late-study period cases revealed significant differences in mean intrathoracic blood loss (174.0 vs. 94.2 mL), number of mediastinal lymph nodes dissected (20.0 vs. 28.4), hospital length of stay (33.4 vs. 20.0 days, p < 0.001), and postoperative anastomotic leakage (14% vs. 1.6%, p < 0.0001).

Conclusions

Standardization of the procedure for thoracoscopic esophagectomy in the left lateral decubitus position, with a standardized clinical pathway for perioperative care led to significant improvements in surgical outcomes.
Literature
1.
Isono K, Ochiai T, Okuyama K, Onoda S. The treatment of lymph node metastasis from esophageal cancer by extensive lymphadenectomy. Jpn J Surg. 1990;20:151–7.CrossRefPubMed
2.
Isono K, Sato H, Nakayama K. Results of a nationwide study on the three-field lymph node dissection of esophageal cancer. Oncology. 1991;48:411–20.CrossRefPubMed
3.
Kato H, Tachimori Y, Mizobuchi S, Igaki H, Ochiai A. Cervical, mediastinal, and abdominal lymph node dissection (three-field dissection) for superficial carcinoma of the thoracic esophagus. Cancer. 1993;72:2879–82.CrossRefPubMed
4.
Watson A. Operable esophageal cancer: current results from the west. World J Surg. 1994;18:361–6.CrossRefPubMed
5.
Cuschieri A, Shimi S, Banting S. Endoscopic oesophagectomy through a right thoracoscopic approach. J R Coll Surg Edinb. 1992;37(1):7–11.PubMed
6.
Akaishi T, Kaneda I, Higuchi N, Kuriya Y, Kuramoto J, Toyoda T, et al. Thoracoscopic en bloc total esophagectomy with radical mediastinal lymphadenectomy. J Thorac Cardiovasc Surg. 1996;112:1533–40. discussion 1540-1541CrossRefPubMed
7.
Kawahara K, Maekawa T, Okabayashi K, Hideshima T, Shiraishi T, Yoshinaga Y, et al. Video-assisted thoracoscopic esophagectomy for esophageal cancer. Surg Endosc. 1999;13:218–23.CrossRefPubMed
8.
Osugi H, Takemura M, Higashino M, Takada N, Lee S, Ueno M, et al. Video-assisted thoracoscopic esophagectomy and radical lymph node dissection for esophageal cancer. A series of 75 cases. Surg Endosc. 2002;16:1588–93.CrossRefPubMed
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 Coll Surg. 2006;203:7–16.CrossRefPubMed
10.
Noshiro H, Iwasaki H, Kobayashi K, Uchiyama A, Miyasaka Y, Masatsugu T, et al. Lymphadenectomy along the left recurrent laryngeal nerve by a minimally invasive esophagectomy in the prone position for thoracic esophageal cancer. Surg Endosc. 2010;24:2965–73.CrossRefPubMed
11.
Daiko H, Nishimura MA. Pilot study of the technical and oncologic feasibility of thoracoscopic esophagectomy with extended lymph node dissection in the prone position for clinical stage I thoracic esophageal carcinoma. Surg Endosc. 2012;26:673–80.CrossRefPubMed
12.
Rusch VW, Rice TW, Crowley J, Blackstone EH, Rami-Porta R, Goldstraw P. The seventh edition of the American joint committee on cancer/International Union against Cancer staging manuals: the new era of data-driven revisions. J Thorac Cardiovasc Surg. 2010;139:819–21.CrossRefPubMed
13.
14.
Tachimori Y, Ozawa S, Numusaki H, Fujishiro M, Matsubara H, Oyama T, et al. Comprehensive registry of esophageal cancer in Japan, 2009. Esophagus. 2016;13:110–37.CrossRefPubMedPubMedCentral
15.
Feng M, Shen Y, Wang H, Tan L, Zhang Y, Khan MA, et al. Thoracolaparoscopic Esophagectomy: is the prone position a safe alternative to the decubitus position. J Am Coll Surg. 2012;214:838–44.CrossRefPubMed
16.
Teshima J, Miyata G, Kamei T, Nakano T, Abe S, Katsura K, et al. Comparison of short-term outcomes between prone and lateral decubitus positions for thoracoscopic esophagectomy. Surg Endosc. 2015;29:2756–62.CrossRefPubMed
17.
Ando N, Kato H, Igaki H, Shinoda M, Ozawa S, Shimizu H, et al. 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. 2012;19:68–74.CrossRefPubMed
18.
Aalbers AGJ, Biere SSAY, van Berge Henegouwen MI, Bemelman WA. Hand-assisted or laparoscopic-assisted approach in colorectal surgery: a systematic review and meta-analysis.
Metadata
Title
Thoracoscopic and hand assisted laparoscopic esophagectomy with radical lymph node dissection for esophageal squamous cell carcinoma in the left lateral decubitus position: a single center retrospective analysis of 654 patients
Authors
Masahiko Murakami
Koji Otsuka
Satoru Goto
Tomotake Ariyoshi
Takeshi Yamashita
Takeshi Aoki
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3743-1

Other articles of this Issue 1/2017

BMC Cancer 1/2017 Go to the issue

Research article

Targeting MCL-1 sensitizes human esophageal squamous cell carcinoma cells to cisplatin-induced apoptosis

Research article

Body mass index modifies the relationship between γ-H2AX, a DNA damage biomarker, and pathological complete response in triple-negative breast cancer

Research article

IGF1R activation and the in vitro antiproliferative efficacy of IGF1R inhibitor are inversely correlated with IGFBP5 expression in bladder cancer

Research article

Effect of genetic variants and traits related to glucose metabolism and their interaction with obesity on breast and colorectal cancer risk among postmenopausal women

Research article

Disease-stabilizing treatment based on all-trans retinoic acid and valproic acid in acute myeloid leukemia – identification of responders by gene expression profiling of pretreatment leukemic cells

Research article

Identifying factors associated with the direction and significance of microRNA tumor-normal expression differences in colorectal cancer
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits