Introduction of thoracoscopic esophagectomy in prone position

Hiroyuki Kitagawa, Tsutomu Namikawa, PhD, Michiya Kobayashi, PhD, Kazuhiro Hanazaki, PhD

Kochi Medical School

BACKGROUND: We have introduced thoracoscopic esophagectomy (TSE) in prone position since July 2009. The aim of this retrospective study is to investigate the short-term result of TSE.

METHODS: We retrospectively reviewed 37 consecutive patients who underwent esophagectomy by TSE between July 2009 and August 2012 at Kochi Medical School to analyze the short outcomes.

RESULTS: There were 32 male patients and 5 female. The median age of patients was 65 (52-85). Thirty patients were squamous cell carcinoma (SCC), 4 were basaloid SCC, and the other 3 were adeno-SCC. Their stage was follows; IA or IB: 16 (43.2%), IIA or IIB: 8 (21.6%), IIIA or IIIB or IIIC: 12 (32.4%), and IV: 1 (2.7%). In abdominal procedure, 31 patients were performed laparoscopic gastric mobilization, 6 were open laparotomy. Eighteen patients (48.6%) had been performed neo-adjuvant chemotherapy. Thirty-two patients (86.5%) had been performed a gastric tube reconstruction, 4 patients (10.8%) were colon, and 1 was 2nd look reconstruction. The median thoracoscopic surgery time was 225 (140-385) min, the volume of blood loss was 220 (40-8381) ml, and the number of dissected lymph nodes was 40 (20-71). One patient died 4 days after the surgery caused by acute respiratory distress syndrome, and 1 patient died 35 days by non-occlusive mesenteric ischemia. We had a patient of left subclavicular artery injury, and converted to open thoracotomy. Nine patients had surgical site infections, 6 had anastomotic leakage, and 3 had pneumonia. The median duration of postoperative hospitalization was 17 (4-90) days. Six patients had recurrence (distant 5, local 1), and 1, 2, 3 year survival rate was 93.8, 69.6, 54.5%.

CONCLUSIONS: The introduction of TSE in our institution was feasible in short outcomes for esophageal cancer patients.

Session: Poster Presentation

Program Number: P201

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