Thoracoscopic Esophagectomy in Prone Position; A Cross-Sectional Study

Seyed Rouhollah Miri; Alireza Khalaj; Vahid Jafarlou; Parham  Khoshdani Farahani; Ayla Bahramian

doi:10.18502/acta.v59i7.7025

Seyed Rouhollah Miri Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
Alireza Khalaj Mostafa Khomeini Hospital, School of Medicine, Shahed University, Tehran, Iran
Vahid Jafarlou Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
Parham Khoshdani Farahani Department of General Surgery, School of Medicine, Lorestan University of Medical Sciences, Lorestan, Iran
Ayla Bahramian Department of Oral Medicine, School of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran

DOI: https://doi.org/10.18502/acta.v59i7.7025

Keywords: Thoracoscopy; Esophagectomy; Prone position

Abstract

Surgical resection with curative intent is still a central therapeutic option for resectable esophageal cancer. Thoracoscopicesophagectomy in a prone position would give each benefit of the lateral position. The present research aimed to analyze the short-term outcomes of thoracoscopicesophagectomy in the prone position. This was a retrospective cross-sectional study. Patients who underwent thoracoscopicesophagectomy in the prone position at Tehran University Cancer institute from January 2017 to December 2018 entered the study. The esophagus was mobilized through the thoracoscopic approach in a prone position. The stomach was released using a laparoscopic approach for the gastric pull-up. Finally, an end-to-end hand-sewn cervical anastomosis was performed. Three, four, seven, one, and one patient suffered from pneumonia, leakage, tracheal tearing, chylothorax, and pneumothorax, respectively, after the operation. In 91.5% of patients, more than ten lymph nodes were resected. Sixty percent of patients were discharged from the hospital earlier than one week. Laparoscopicesophagectomy in the prone position is a feasible alternative. Better exposure and fewer complications were reported.