scholarly journals Thoracoscopic Esophagectomy with the Patient in the Prone Position

2009 ◽  
Vol 5 (4) ◽  
pp. 211-214 ◽  
Author(s):  
Takeshi Matsutani ◽  
Eiji Uchida ◽  
Hiroshi Maruyama ◽  
Koji Nishikawa ◽  
Koki Yamada ◽  
...  
Keyword(s):  
Prone Position ◽  
Thoracoscopic Esophagectomy

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

2016 ◽  
Vol 31 (3) ◽  
pp. 1136-1141 ◽  
Author(s):  
Dai Otsubo ◽  
Tetsu Nakamura ◽  
Masashi Yamamoto ◽  
Shingo Kanaji ◽  
Kiyonori Kanemitsu ◽  
...  
Keyword(s):  
Prone Position ◽  
Pulmonary Complications ◽  
Thoracoscopic Esophagectomy ◽  
Postoperative Oxygenation

PS02.006: OPERATIVE INDICATION AND PROCEDURES OF THORACOSCOPIC ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 121-121
Author(s):  
Takashi Kamei
Keyword(s):  
Esophageal Cancer ◽  
Survival Rate ◽  
Prone Position ◽  
Neoadjuvant Treatment ◽  
Thoracoscopic Esophagectomy ◽  
Operative Indication ◽  
Definitive Chemoradiotherapy ◽  
Long Term Outcome ◽  
Thoracoscopic Approach ◽  
Left Lateral Decubitus Position

Abstract Background Thoracoscopic esophagectomy has been performed for two decades and becomes widely spread. We evaluate our cases who undergone the thoracoscopic esophagectomy and consider the future prospective of this operation. Methods 702 patients who received thoracoscopic esophagectomy in our institute from March 1995 to October 2017 were enrolled and studied retrospectively. Operative indication is an all of the clinically resectable cases including with a neoadjuvant treatment or definitive chemoradiotherapy before surgery. Overall survival rate of the patients with thoracoscopic approach and with thoracotomy until 2001 was analyzed. Long term outcome of the patients with thoracoscopic esophagectomy was compared to the result from comprehensive registry of esophageal cancer in Japan. Short term results of the perioperative parameters were analyzed between left lateral decubitus position and prone position. Results There was no significant differences of the survival rate between thoracoscopic group and thoracotomy group based on pathological stage. 5 year survival without neoadjuvant treatment was 88.9% (pStageI), 71.5%(pStageIIA), 68.1%(pStageIIB), 40.9%(pStageIII), respectively.5 year survival rate of cStageII and III with neoadjuvant chemotherapy was 65.7% and 5 year survival rate of the salvage esophagectomy after failure of definitive chemoradiotherapy was 31.4%. Every outcomes are as good as any reported results in esophagectomy. In the comparison of the lateral position with the prone position, total blood loss was significantly lower in prone position. Inflammatory response after surgery was improved more rapidly in prone group, therefore, prone position is recommended as a minimally invasive procedure for thoracoscopic esophagectomy. Conclusion Thoracoscopic esophagectomy will develop further as a standard operation for esophageal cancer. However, from the point of view of the safety, an appropriate educational systems of this advanced procedure should build. Disclosure All authors have declared no conflicts of interest.

VS01.04: RELIABLE SURGICAL TECHNIQUES FOR LYMPHADENECTOMY ALONG THE LEFT RECURRENT LARYNGEAL NERVE DURING THORACOSCOPIC ESOPHAGECTOMY IN THE PRONE POSITION

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 44-44
Author(s):  
Taro Oshikiri ◽  
Tetsu Nakamura ◽  
Hiroshi Hasegawa ◽  
Masashi Yamamoto ◽  
Shingo Kanaji ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Recurrent Laryngeal Nerve ◽  
Prone Position ◽  
Conflicts Of Interest ◽  
Surgical Techniques ◽  
Laryngeal Nerve ◽  
Thoracoscopic Esophagectomy ◽  
Left Recurrent Laryngeal Nerve

Abstract Description Background Lymphadenectomy along the left recurrent laryngeal nerve (RLN) in esophageal cancer is important for disease control but requires advanced dissection skills. Complete dissection of the lymph nodes along the left RLN in a safe manner is important. We demonstrate the reliable method for lymphadenectomy along the left RLN during thoracoscopic esophagectomy in the prone position (TEP). Methods This procedure is performed for all of resectable thoracic esophageal cancers. The essence of this method is to recognize the lateral pedicle as a two-dimensional membrane that inclu replicatedes the left RLN, lymph nodes around the nerve, and primary esophageal arteries. By drawing the proximal portion of the divided esophagus and the lateral pedicle, identification and reliable cutting of the primary esophageal arteries and distinguishing the left RLN from the lymph nodes are simplified. Results We performed 46 TEPs for esophageal cancer using this method with no conversion to an open procedure in 2015 at Kobe University. No intraoperative morbidity related to the left RLN was observed. The mean number of harvested lymph nodes along the left RLN was 6.9 ± 4.2. Left RLN palsy greater than Clavien-Dindo classification grade II occurred in 4 patients (8%), all of them were reversible. The incidence of lymph node metastasis along the left RLN was 22%. Conclusion Our method for lymphadenectomy along the left RLN during TEP is safe and reliable. It has a low incidence of left RLN palsy and provides sufficient lymph node dissection along the left RLN. Disclosure All authors have declared no conflicts of interest.

Thoracoscopic esophagectomy in the prone position

2012 ◽  
Vol 26 (8) ◽  
pp. 2095-2103 ◽  
Author(s):  
Omar A. Jarral ◽  
Sanjay Purkayastha ◽  
Thanos Athanasiou ◽  
Ara Darzi ◽  
George B. Hanna ◽  
...  
Keyword(s):  
Prone Position ◽  
Thoracoscopic Esophagectomy

RA04.01: PRONE POSITION IN THORACOSCOPIC ESOPHAGECTOMY IMPROVES POSTOPERATIVE OXYGENATION AND REDUCES PULMONARY COMPLICATIONS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 24-25
Author(s):  
Yoshihiro Kakeji ◽  
Dai Otsubo ◽  
Gosuke Takiguchi ◽  
Taro Oshikiri ◽  
Tetsu Nakamura
Keyword(s):  
Pulmonary Function ◽  
Prone Position ◽  
Surgical Procedure ◽  
Body Position ◽  
Lateral Decubitus Position ◽  
Thoracoscopic Esophagectomy ◽  
Respiratory Complications ◽  
Left Lateral Decubitus Position ◽  
Lateral Decubitus ◽  
Position Group

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 From a surgical point of view, artificial pneumothorax and gravity improves the operative field view in the prone position without any compression of the right lung, thereby resulting in no mechanical damage to the lungs. Prone position esophagectomy is a useful surgical technique, which appears to preserve the postoperative pulmonary function. The patients are able to endure the surgical procedure and present with less respiratory complications. Disclosure All authors have declared no conflicts of interest.

Microanatomy-based standardization of left upper mediastinal lymph node dissection in thoracoscopic esophagectomy in the prone position

2020 ◽  
Vol 35 (1) ◽  
pp. 349-357 ◽  
Author(s):  
Yasuhiro Shirakawa ◽  
Kazuhiro Noma ◽  
Naoaki Maeda ◽  
Shunsuke Tanabe ◽  
Kazufumi Sakurama ◽  
...  
Keyword(s):  
Lymph Node ◽  
Prone Position ◽  
Lymph Node Dissection ◽  
Mediastinal Lymph Node ◽  
Mediastinal Lymph Node Dissection ◽  
Thoracoscopic Esophagectomy ◽  
Node Dissection

scholarly journals Practical Surgical Techniques for Lymphadenectomy Along the Right Recurrent Laryngeal Nerve During Thoracoscopic Esophagectomy in the Prone Position

2017 ◽  
Vol 24 (8) ◽  
pp. 2302-2302 ◽  
Author(s):  
Taro Oshikiri ◽  
Tetsu Nakamura ◽  
Yukiko Miura ◽  
Hiroshi Hasegawa ◽  
Masashi Yamamoto ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Prone Position ◽  
Surgical Techniques ◽  
Laryngeal Nerve ◽  
Thoracoscopic Esophagectomy ◽  
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