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Outcomes of thoracoscopic esophagectomy in prone position with laparoscopic gastric mobilization for esophageal cancer

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Abstract

Purpose

The aim of this study was to evaluate the short- and long-term outcomes of thoracoscopic esophagectomy performed in the prone position (TSE-PP) followed by laparoscopic gastric mobilization (LGM) compared with open thoracotomy and LGM, for esophageal cancers.

Methods

We reviewed the records of 105 consecutive patients who underwent esophagectomy with LGM for esophageal cancer at Kochi Medical School. Among the study patients, 60 patients underwent TSE-PP, while 45 underwent open thoracotomy (OPEN group). The perioperative outcomes of the two groups were compared.

Results

Compared to the OPEN group, the TSE-PP group had lower blood loss (TSE-PP, 150 mL; OPEN, 430 mL; P < 0.001), longer operative time (TSE-PP, 609 min; OPEN, 570 min; P = 0.012), more lymph nodes dissected around the left recurrent laryngeal nerve (TSE-PP, 6; OPEN, 2; P < 0.001), and a shorter length of hospital stay (TSE-PP, 16.5 days; OPEN, 35 days; P < 0.001). The incidence of postoperative complications was similar in the two groups. Though the recurrence rate and overall survival were not significantly different in the two groups, the TSE-PP group had better overall survival rates than the OPEN group (P = 0.122).

Conclusions

Patients who underwent TSE-PP with LGM for esophageal cancers recovered earlier after surgery compared to those who underwent open thoracotomy with LGM.

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Authors and Affiliations

  1. Department of Surgery, Kochi Medical School, Kochi, Japan

    Hiroyuki Kitagawa, Tsutomu Namikawa, Masaya Munekage, Kazune Fujisawa, Eri Munekgae & Kazuhiro Hanazaki

  2. Department of Human Health and Medical Sciences, Kochi Medical School, Kochi, Japan

    Michiya Kobayashi

Authors
  1. Hiroyuki Kitagawa
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  2. Tsutomu Namikawa
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  3. Masaya Munekage
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  4. Kazune Fujisawa
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  5. Eri Munekgae
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  6. Michiya Kobayashi
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  7. Kazuhiro Hanazaki
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Corresponding author

Correspondence to Tsutomu Namikawa.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study, formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Authors’ contributions

Study conception and design were performed by Hiroyuki Kitagawa. Acquisition of data was made by Hiroyuki Kitagawa, Masaya Munekage, Kazune Fujisawa, and Eri Munekage. Analysis and interpretation of data was performed by Hiroyuki Kitagawa and Michiya Kobayashi. Drafting of manuscript was executed by Hiroyuki Kitagawa, and critical revision of manuscript was done by Tsutomu Namikawa and Kazuhiro Hanazaki.

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Kitagawa, H., Namikawa, T., Munekage, M. et al. Outcomes of thoracoscopic esophagectomy in prone position with laparoscopic gastric mobilization for esophageal cancer. Langenbecks Arch Surg 401, 699–705 (2016). https://doi.org/10.1007/s00423-016-1446-8

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  • DOI: https://doi.org/10.1007/s00423-016-1446-8

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