Thoracoscopic Esophagectomy Using Prone Positioning

Noshirο, Hirokazu; Miyake, Shuusuke

doi:10.5761/atcs.ra.13-00262

Cited by 32 publications

(34 citation statements)

References 67 publications

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“…However, the limitation of this approach for an aesthesia intubation is that it may cause difficulties in intraoperative converting the procedure to open thoracotomy, which could be settled by an endobronchial blocker tube, and that it is plausible to affect function of left thoracic cavity if the pleura is broken during the procedure (8).…”

Section: Discussionmentioning

confidence: 99%

“…R e g a r d l e s s o f w h e t h e r s q u a m o u s c a r c i n o m a o r adenocarcinoma, perioperative mortality is high (8,9,13), and respiratory complication is one of the most significant factors that impacts the perioperative outcomes (8,14).…”

Section: Discussionmentioning

confidence: 99%

“…Thus, it has been a continuing quest to search for better method with convenience, safe and least-trauma in managing anesthesia intubation for thoracoscopicesophagectomy (8).…”

Section: Introductionmentioning

confidence: 99%

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Better perioperative outcomes in thoracoscopic-esophagectomy with two-lung ventilation in semi-prone position

Li¹,

Sun²,

Yang³

et al. 2017

J. Thorac. Dis.

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Background: One-lung ventilation (OLV) anesthesia intubation route is often used in patients undergoing thoracoscopic-esophagectomy in semi-prone position. Recently, the two-lung ventilation (TLV) approach becomes popular. However, limited studies have compared the two ventilation approaches in parallel. Here, we report a single-center, retrospective study of comparing TLV and OLV approach in patients undergoing thoracoscopic-esophagectomy in semi-prone position. Conclusion: This study demonstrated that TLV intubation approach is superior to OLV approach during the thoracoscopic-esophagectomy in semi-prone position. According to this, TLV approach is a technically feasible, convenient and safe anesthesia induction approach for esophageal cancer surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Better perioperative outcomes in thoracoscopic-esophagectomy with two-lung ventilation in semi-prone position

Li¹,

Sun²,

Yang³

et al. 2017

J. Thorac. Dis.

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“…The MIMK was chosen as the next refinement of the technique since a member of the team was familiar with the procedure after a long fellowship abroad and additionally due to the familiarity, within the team, in performance of cervical anastomosis, thus avoiding the technically more complex minimal invasive intrathoracic anastomosis. The prone position was selected as the positioning of choice because of enhanced visualization, improved surgeon's ergonomics as well as the advantage of double lung ventilation allowing better oxygenation and reducing the risk of postoperative pulmonary complications (22,23).…”

Section: Discussionmentioning

confidence: 99%

Implementation of minimally invasive esophagectomy in a tertiary referral center for esophageal cancer

et al. 2017

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years, high morbidity rates are still recorded (5,6). In an effort to reduce the postoperative morbidity associated with open esophagectomy various minimally invasive esophagectomy (MIE) techniques have been introduced and developed during the recent years. MIE is believed to minimize the surgical trauma and subsequently the postoperative pain resulting in a faster mobilization and recovery with reduced postoperative complication rates and shorter hospital stay compared to the open procedure. During the last 20 years several studies have been published within the field demonstrating that MIE is a safe technique with an oncological outcome at least equal to open esophagectomy with regard to complete resection rate, number of lymph nodes harvested and postoperative survival (7-9). Moreover, there is an indication of shortterm benefits after MIE especially with regards to reduced pulmonary complications and improved health related quality of life compared to the open procedure (10,11).The aim of the current study was to present our 4.5-year experience of the gradual implementation of various MIE techniques in our tertiary referral center with special focus on the evolution of adaptive changes and refinements of our practice of the procedure over this period. Methods Our unitCenter of digestive diseases (CDD) at Karolinska University Hospital, Stockholm is one of the largest and most highly specialized centers in the Nordic countries. It is a tertiary referral center in Stockholm County with a catchment area of approximately 2,500,000 inhabitants. Furthermore, CDD receives referrals for patients with newly diagnosed esophageal and cardia cancer from neighboring counties with an additional population of 650,000. This results in an annual case volume of 40-60 esophageal and resections in the most recent years.The Unit engages three consultant surgeons (MN, ML, IR), with long laparoscopic experience within benign upper gastrointestinal (UGI) surgery as well as long previous experience in open esophageal cancer surgery. Karolinska, Stockholm. From 2009, one of the current consultant surgeons, IR, spent 3 years in a fellowship in UGI cancer surgery at Bristol Royal Infirmary, Bristol, UK with special focus in MIE. During these years he became confident in both the hybrid laparoscopic assisted esophagectomy (HLAE) technique including laparoscopic gastric mobilization and abdominal lymph node dissection followed by thoracotomy and intrathoracic anastomosis as well as with the minimal invasive McKeown (MIMK) technique, i.e., thoracolaparoscopy followed by cervical anastomosis by performing more than 70 cases. In the meantime, two other consultant surgeons (MN & ML) had the chance to visit another center with extensive In May 2012 and as a first test of transition to MIE, the first HLAE was performed safely with all consultants present. This was followed shortly by an additional procedure with satisfactory results and without any technical problems to be encountered. HLAE was chosen as the most feasible MIE in the beginning...

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“…Thoracoscopic surgery for esophageal cancer is often performed as a type of minimally invasive surgery (13)(14)(15)(16)(17). Although its importance as a minimally invasive procedure has been controversial to date, the reduction in blood loss that results from being able to recognize fine structure is a merit of thoracoscopic surgery (18).…”

Section: Discussionmentioning

confidence: 99%

Effective Mediastinal Lymphadenectomy for Esophageal Cancer Using Slender Tracheal Forceps in Prone Position Thoracoscopic Esophagectomy

Nakajima

Takahashi

Domeki

et al. 2016

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Thoracoscopic Esophagectomy Using Prone Positioning

Cited by 32 publications

References 67 publications

Better perioperative outcomes in thoracoscopic-esophagectomy with two-lung ventilation in semi-prone position

Better perioperative outcomes in thoracoscopic-esophagectomy with two-lung ventilation in semi-prone position

Implementation of minimally invasive esophagectomy in a tertiary referral center for esophageal cancer

Effective Mediastinal Lymphadenectomy for Esophageal Cancer Using Slender Tracheal Forceps in Prone Position Thoracoscopic Esophagectomy

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