Skip to main content
SpringerLink
Log in

Lateral position could provide more excellent hemodynamic parameters during video-assisted thoracoscopic esophagectomy for cancer

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Thoracoscopic esophagectomy is a feasible technique that has been shown to be safe for the treatment of esophageal cancer. There continues to be controversy about the optimal position during thoracoscopic esophagectomy. In this study, we compared the intraoperative hemodynamic parameters, clinical pathological characteristics, as well as postoperative complications in patients who underwent thoracoscopic esophagectomy in the prone position (PP) or left-lateral decubitus position (LDP).

Methods

Between January 2011 and June 2011, 23 patients underwent thoracoscopic esophagectomies for cancer of the esophagus in LDP (group A). Since February 2011, we have performed thoracoscopic esophagectomies for cancer of the esophagus in PP for 21 patients (group B). The demographics and clinicopathologic factors, as well as the intraoperative hemodynamic parameters, of the two groups were analyzed.

Results

No postoperative death occurred in these 44 patients. Overall morbidity was similar in the two groups. No significant difference in the length of operation or number of retrieved mediastinal nodes between the two groups was observed, but the intraoperative blood loss in group A was significantly higher than in group B (P = 0.0228). There was no significant difference of the intraoperative mean arterial pressure, central venous pressure, heart rate, and stroke volume variation between the two groups and various positions. In group A, the cardiac output (CO), cardiac index (CI), as well as stroke volume index (SVI) did not exhibit significant difference after altering patients’ position from LDP to SP. However, patients who underwent thorascopic esophagectomy in PP had lower CO, CI, and SVI than in LDP during the thoracoscopic stage.

Conclusions

Compared with the PP, the LDP could provide more excellent hemodynamic parameters during thoracoscopic esophagectomy. However, the various hemodynamic statuses did not exert significant influence on the occurrence of postoperative complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, Thun MJ (2008) Cancer statistics, 2008. CA Cancer J Clin 58:71–96

    Article  PubMed  Google Scholar 

  2. Enzinger PC, Mayer RJ (2003) Esophageal cancer. N Engl J Med 349:2241–2252

    Article  PubMed  CAS  Google Scholar 

  3. Cuschieri A, Shimi S, Banting S (1992) Endoscopic oesophagectomy through a right thoracoscopic approach. J R Coll Surg Edinb 37:7–11

    PubMed  CAS  Google Scholar 

  4. Law S, Fok M, Chu KM, Wong J (1997) Thoracoscopic esophagectomy for esophageal cancer. Surgery 122:8–14

    Article  PubMed  CAS  Google Scholar 

  5. Taguchi S, Osugi H, Higashino M, Tokuhara T, Takada N, Takemura M, Lee S, Kinoshita H (2003) Comparison of three-field esophagectomy for esophageal cancer incorporating open or thoracoscopic thoracotomy. Surg Endosc 17:1445–1450

    Article  PubMed  CAS  Google Scholar 

  6. Fukunaga T, Kidokoro A, Fukunaga M, Nagakari K, Suda M, Yoshikawa S (2001) Kinetics of cytokines and PMN-E in thoracoscopic esophagectomy. Surg Endosc 15:1484–1487

    PubMed  CAS  Google Scholar 

  7. Osugi H, Takemura M, Higashino M, Takada N, Lee S, Kinoshita H (2003) A comparison of video-assisted thoracoscopic oesophagectomy and radical lymph node dissection for squamous cell cancer of the oesophagus with open operation. Br J Surg 90:108–113

    Article  PubMed  CAS  Google Scholar 

  8. Palanivelu C, Prakash A, Senthilkumar R, Senthilnathan P, Parthasarathi R, Rajan PS, Venkatachlam S (2006) Minimally invasive esophagectomy: thoracoscopic mobilization of the esophagus and mediastinal lymphadenectomy in prone position: experience of 130 patients. J Am Coll Surg 203:7–16

    Article  PubMed  Google Scholar 

  9. Jarral OA, Purkayastha S, Athanasiou T, Zacharakis E (2011) Should thoracoscopic three-stage esophagectomy be performed in the prone or left lateral decubitus position? Interact Cardiovasc Thorac Surg 13:60–65

    Article  PubMed  Google Scholar 

  10. Guo W, Zhao YP, Jiang YG, Niu HJ, Liu XH, Ma Z, Wang RW (2012) Prevention of postoperative chylothorax with thoracic duct ligation during video-assisted thoracoscopic esophagectomy for cancer. Surg Endosc 26:1332–1336

    Article  PubMed  Google Scholar 

  11. Luketich JD, Alvelo-Rivera M, Buenaventura PO, Christie NA, McCaughan JS, Litle VR, Schauer PR, Close JM, Fernando HC (2003) Minimally invasive esophagectomy: outcomes in 222 patients. Ann Surg 238:486–494

    PubMed  Google Scholar 

  12. Luketich JD, Schauer PR, Christie NA, Weigel TL, Raja S, Fernando HC, Keenan RJ, Nguyen NT (2000) Minimally invasive esophagectomy. Ann Thorac Surg 70:906–911

    Article  PubMed  CAS  Google Scholar 

  13. Luketich JD, Pennathur A, Awais O, Levy RM, Keeley S, Shende M, Christie NA, Weksler B, Landreneau RJ, Abbas G, Schuchert MJ, Nason KS (2012) Outcomes after minimally invasive esophagectomy: review of over 1,000 patients. Ann Surg 256:95–103

    Article  PubMed  Google Scholar 

  14. Biere SS, van Berge Henegouwen MI, Maas KW, Bonavina L, Rosman C, Garcia JR, Gisbertz SS, Klinkenbijl JH, Hollmann MW, de Lange ES, Bonjer HJ, van der Peet DL, Cuesta MA (2012) Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet 379:1887–1892

    Article  PubMed  Google Scholar 

  15. Butler N, Collins S, Memon B, Memon MA (2011) Minimally invasive oesophagectomy: current status and future direction. Surg Endosc 25:2071–2083

    Article  PubMed  Google Scholar 

  16. Watson DI, Davies N, Jamieson GG (1999) Totally endoscopic Ivor Lewis esophagectomy. Surg Endosc 13:293–297

    Article  PubMed  CAS  Google Scholar 

  17. Fabian T, McKelvey AA, Kent MS, Federico JA (2007) Prone thoracoscopic esophageal mobilization for minimally invasive esophagectomy. Surg Endosc 21:1667–1670

    Article  PubMed  CAS  Google Scholar 

  18. Puntambekar SP, Agarwal GA, Joshi SN, Rayate NV, Sathe RM, Patil AM (2010) Thoracolaparoscopy in the lateral position for esophageal cancer: the experience of a single institution with 112 consecutive patients. Surg Endosc 24:2407–2414

    Article  PubMed  Google Scholar 

  19. Edgcombe H, Carter K, Yarrow S (2008) Anaesthesia in the prone position. Br J Anaesth 100:165–183

    Article  PubMed  CAS  Google Scholar 

  20. Dharmavaram S, Jellish WS, Nockels RP, Shea J, Mehmood R, Ghanayem A, Kleinman B, Jacobs W (2006) Effect of prone positioning systems on hemodynamic and cardiac function during lumbar spine surgery: an echocardiographic study. Spine (Phila Pa 1976) 31:1388–1393

    Article  Google Scholar 

  21. Yokoyama M, Ueda W, Hirakawa M, Yamamoto H (1991) Hemodynamic effect of the prone position during anesthesia. Acta Anaesthesiol Scand 35:741–744

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

Disclosures

Drs. Ying-Bo Zou, Hong Yan, Xue-Hai Liu, Yin-Jie Zhao, Yao-Guang Jiang, Ru-Wen Wang, and Wei Guo have no conflict of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Changjiang Route 10#, Daping, Chongqing, 400042, People’s Republic of China

    Ying-Bo Zou, Xue-Hai Liu, Yao-Guang Jiang, Ru-Wen Wang & Wei Guo

  2. Department of Anesthesiology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, People’s Republic of China

    Hong Yan & Yin-Jie Zhao

Authors
  1. Ying-Bo Zou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hong Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xue-Hai Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yin-Jie Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yao-Guang Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ru-Wen Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Wei Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wei Guo.

Additional information

Ying-Bo Zou and Hong Yan contributed equally to this study.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zou, YB., Yan, H., Liu, XH. et al. Lateral position could provide more excellent hemodynamic parameters during video-assisted thoracoscopic esophagectomy for cancer. Surg Endosc 27, 3720–3725 (2013). https://doi.org/10.1007/s00464-013-2953-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-013-2953-0

Keywords

Search

Navigation