Muscle sparing thoracotomy for esophageal cancer: a comparison with posterolateral thoracotomy

Miyata, Kazushi; Fukaya, Masahide; Itatsu, Keita; T, Abe; Nagino, Masato

doi:10.1007/s00595-015-1240-1

Cited by 14 publications

(7 citation statements)

References 25 publications

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“…Open thoracotomy for the treatment of thoracic esophageal cancer is associated with intense acute postoperative pain. 1 Single-injection erector spinae plane block (ESPB) has been reported to be successfully used for analgesia after thoracotomy. 2 Although ESPB is effective for alleviating pain after thoracotomy, the duration of analgesia is not long enough.…”

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confidence: 99%

Dexmedetomidine Added to Ropivacaine for Ultrasound-guided Erector Spinae Plane Block Prolongs Analgesia Duration and Reduces Perioperative Opioid Consumption After Thoracotomy

Wang

Wei

et al. 2021

The Clinical Journal of Pain

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Objectives: Single-injection erector spinae plane block (ESPB) provides good control of pain relief after open thoracotomy surgeries. However, the duration of pain relief does not last long. For this purpose, we hypothesized that adding α 2 -adrenoceptor agonist, dexmedetomidine, for interfascial nerve blockade may increase the duration of analgesia. There are only few studies using dexmedetomidine for interfasical nerve blocks in humans. In this study, our aim is to investigate whether addition of dexmedetomidine to ropivacaine for ESPB could effectively prolong the duration of postoperative analgesia and reduce opioid consumption after open thoracotomy. Materials and Methods: Sixty patients with esophageal cancer were randomized to receive ESPB using 28 mL of 0.5% ropivacaine, with 2 mL of normal saline (group R) or 0.5 µg/kg dexmedetomidine in 2 mL (group RD) administered interfascially. ESPB was performed at the fifth thoracic level under ultrasound guidance. The primary outcome was the duration of analgesia. The secondary outcomes were total postoperative sufentanil consumption, Numeric Rating Scale pain scores, Ramsay Sedation Scale scores and adverse effects. Results: The duration of analgesia in group RD (505.1±113.9) was longer than that in group R (323.2±75.4) ( P <0.001). The total postoperative sufentanil consumption was lower in group RD (23.3±10.0) than in group R (33.8±13.8) ( P =0.001). There was no significant difference in the incidence of adverse effects between the 2 groups. Conclusion: After open thoracotomy, addition of dexmedetomidine to ropivacaine for ESPB effectively prolonged the duration of postoperative analgesia and reduced opioid consumption without increasing additional incidence of adverse effects.

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confidence: 99%

Dexmedetomidine Added to Ropivacaine for Ultrasound-guided Erector Spinae Plane Block Prolongs Analgesia Duration and Reduces Perioperative Opioid Consumption After Thoracotomy

Wang

Wei

et al. 2021

The Clinical Journal of Pain

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“…Also, in Alavi et al 2 paper which is in line with this study they found no significant difference between the two groups in term of the length of hospitalization. In contrary, Miyata et al 15 , Kucukarslan et al 13 , and Nosotti et al 19 reported this duration for MST significantly different and shorter than PLT group. In terms of thoracotomy complications, different studies concluded that there was no significant difference in rates in both groups 19 , 25 , 26 .…”

Section: Discussionmentioning

confidence: 91%

Muscle-Sparing Versus Standard Posterolateral Thoracotomy in Neonates With Esophageal Atresia

Askarpour

Peyvasteh

Ashrafi

et al. 2018

ABCD, arq. bras. cir. dig.

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Background : The muscle-sparing thoracotomy (MST) has not yet been thoroughly studied and assessed in comparison to the traditional thoracotomy method in newborns. Aim : To compare the outcomes of MST and standard posterolateral thoracotomy (PLT) in newborns. Methods : Randomized, controlled, double-blind trial on 40 neonates with esophageal atresia, comparing the time of beginning a surgery until seeing the pleura, the duration of hospitalization in the neonatal intensive care unit, the time in ventilator, the time of returning the shoulder function, the time of returning the Moro reflex, and the mortality between the two techniques. Results : The data showed no differences between the two groups in basic information (weight, height, gender, numbers of prematurity neonates and caesarean). The results on the size of the scar in the MST group was significantly lower than in the PLT group. Also, the time of returning the shoulder function in MST group was earlier than in PLT group. There were no significant differences in the duration since the beginning the surgery to see the pleura, the time of being hospitalized in intensive unit, the time that the infant required ventilator, returning time of the Moro reflex in 1st and 3rd months after the operation, and the mortality rates between MST and PLT groups. Conclusion : It seems that the advantages of using MST over PLT procedure in neonates include the earlier shoulder function recovery and also superior cosmetic results.

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“…These hormones act on myocardial and vascular smooth muscle, causing sodium-water retention in the body, resulting in an increase in extravascular lung water (EVLW), which in turn leads to an abnormal ventilation/blood flow ratio. Finally, postoperative incisional pain after OE greatly limits the cough and expectoration of the patients, and increased alveolar exudate causes postoperative obstructive respiratory impairment, which impairs pulmonary ventilation and exchange function [ 25 ]. In addition, incisional pain affects forced breathing, resulting in a decrease in exhaled air and a significant increase in residual air.…”

Section: Discussionmentioning

confidence: 99%

The influence of minimally invasive esophagectomy versus open esophagectomy on postoperative pulmonary function in esophageal cancer patients: a meta-analysis

Sui

et al. 2022

J Cardiothorac Surg

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Objective To compare the influence of minimally invasive esophagectomy (MIE) and open esophagectomy (OE) on postoperative pulmonary function in patients with esophageal cancer. Methods Studies about the influence of MIE and OE on postoperative pulmonary function in esophageal cancer patients were searched from PubMed, EMBASE, the Cochrane Library, CNKI, Chinese Science and Technology Journal Database, CBM, and Wanfang Data from inception to March 18, 2021. Meta-analysis was performed using the RevMan 5.3. Results This analysis included eight studies, enrolling 264 patients who underwent MIE and 257 patients who underwent OE. The meta-analysis results showed that the MIE group had a higher outcome regarding the percent predicted vital capacity (%VC), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and maximum voluntary ventilation (MVV) 1 month after surgery than the OE group. In addition, those who underwent MIE had lower ΔVC%, ΔFVC, and ΔFEV1 between pre-operation and 1 month after surgery than those who underwent OE. There is no statistical difference between the two groups in ΔMVV. Conclusion Compared with OE, MIE has a more protective effect on postoperative pulmonary function. However, due to the small number of included literature and all cohort studies, this finding needs to be validated with larger samples and higher quality RCT studies.

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Muscle sparing thoracotomy for esophageal cancer: a comparison with posterolateral thoracotomy

Abstract: Compared with PLT, MST might, therefore, reduce postoperative chest pain and offer a better recovery of pulmonary function in patients with esophageal cancer.

Cited by 14 publications

References 25 publications

Dexmedetomidine Added to Ropivacaine for Ultrasound-guided Erector Spinae Plane Block Prolongs Analgesia Duration and Reduces Perioperative Opioid Consumption After Thoracotomy

Dexmedetomidine Added to Ropivacaine for Ultrasound-guided Erector Spinae Plane Block Prolongs Analgesia Duration and Reduces Perioperative Opioid Consumption After Thoracotomy

Muscle-Sparing Versus Standard Posterolateral Thoracotomy in Neonates With Esophageal Atresia

The influence of minimally invasive esophagectomy versus open esophagectomy on postoperative pulmonary function in esophageal cancer patients: a meta-analysis

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