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Esophageal Position Affects Short-Term Outcomes After Minimally Invasive Esophagectomy: A Retrospective Multicenter Study

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Abstract

Background

Anatomical esophageal position may affect the short-term outcomes after minimally invasive esophagectomy (MIE). A previous single-institutional retrospective study suggested that the presence of a left-sided esophagus (LSE) made MIE more difficult and increased the incidence of postoperative complications.

Methods

The current study was a multicenter retrospective study of 303 patients with esophageal cancer who underwent MIE at six esophageal cancer high-volume centers in Kyushu, Japan, between April 2011 and August 2016. The patients were divided into the LSE (66 patients) and non-LSE groups (237 patients) based on the esophageal position on computed tomography images obtained with the patients in the supine position.

Results

Univariate analysis showed that patients with LSE were significantly older than those with non-LSE (69 ± 8 vs. 65 ± 9 years; P = 0.002), had a significantly greater incidence of cardiovascular comorbidity (65.2% vs. 47.7%; P = 0.013), and a significantly longer operating time (612 ± 112 vs. 579 ± 102 min; P = 0.025). Logistic regression analysis verified that LSE was an independent risk factor for the incidence of pneumonia (odds ratio 3.3, 95% confidence interval 1.254–8.695; P = 0.016).

Conclusions

The presence of a LSE can increase the procedural difficulty of MIE and the incidence of morbidity after MIE. Thus, careful attention must be paid to anatomical esophageal position before performing MIE.

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Acknowledgements

We thank Kelly Zammit, BVSc, and Cathel Kerr, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan

    Tomoyuki Uchihara, Naoya Yoshida, Yoshifumi Baba & Hideo Baba

  2. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Yuichiro Nakashima, Hiroshi Saeki & Yoshihiko Maehara

  3. Department of Surgery, Iizuka Hosipital, Yoshiomachi 3-83, Iizuka, Fukuoka, 820-8505, Japan

    Yasue Kimura

  4. Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka, 810-0001, Japan

    Noriaki Sadanaga

  5. Department of Gastroenterological Surgery, National Hospital Organization, Kyushu Cancer Center, 3-1-1 Notame, Miniami-ku, Fukuoka, 811-1395, Japan

    Masahiko Ikebe, Masaru Morita & Yasushi Toh

  6. Division of Gastrointestinal-Endocrine-Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki, Kihara 5200, Kiyotake, Miyazaki, 889-1692, Japan

    Shinsuke Takeno & Atsushi Nanashima

Authors
  1. Tomoyuki Uchihara
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  2. Naoya Yoshida
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  3. Yoshifumi Baba
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  9. Masahiko Ikebe
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  10. Masaru Morita
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  11. Yasushi Toh
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  13. Yoshihiko Maehara
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  14. Hideo Baba
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Correspondence to Hideo Baba.

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Uchihara, T., Yoshida, N., Baba, Y. et al. Esophageal Position Affects Short-Term Outcomes After Minimally Invasive Esophagectomy: A Retrospective Multicenter Study. World J Surg 44, 831–837 (2020). https://doi.org/10.1007/s00268-019-05273-8

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  • DOI: https://doi.org/10.1007/s00268-019-05273-8

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