Open AccessMinimally invasive esophagectomy in the lateral‐prone position: Experience of 124 cases in a single center
Author(s) -
Ma Shaohua,
Yan Tianshen,
Liu Dandan,
Wang Keyi,
Wang Jingdi,
Song Jintao,
Wang Tong,
He Wei,
Bai Jie,
Jin Liang
Publication year - 2018
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.12524
Subject(s) - medicine , prone position , single center , esophagectomy , position (finance) , surgery , center (category theory) , esophageal cancer , cancer , chemistry , finance , economics , crystallography
Background Minimally invasive esophagectomy was first introduced as a new technique for esophageal cancer treatment 20 years ago. Performing this procedure in the lateral‐prone position is the most appropriate method. Since May 2013, our center has performed 124 esophageal cancer operations using this procedure. Herein, we share our experience. Methods We retrospectively reviewed 124 consecutive patients who had received minimally invasive esophagectomy in the lateral‐prone position from May 2013 to June 2017. The procedure, operative variables, postoperative complications, and oncology outcomes were assessed. Results The surgery was successful in all 124 patients; three cases converted to an abdominal opening procedure during surgery. The mean total lymph node harvest was 19.2: 12.9 in the thoracic cavity and 6.0 in the abdominal cavity. The average total operation duration was 376 minutes and blood loss was 156 mL. No mortality occurred within 30 postoperative days. Forty‐three cases of postoperative morbidity occurred in 38 patients (30.6%), including 11 anastomotic leakages (8.9%), 1 chyle leak (0.8%), 12 lateral recurrent nerve palsies (9.7%), 11 pulmonary complications (8.9%), and 8 other complications (6.5%). A learning curve indicated that blood loss, operation duration, and the number of lymph nodes harvested would improve with time. Conclusions Surgical and oncological outcomes following minimally invasive esophagectomy for esophageal cancer were acceptable. There are some advantages to this technique compared to previous reports of opening procedures.