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Thoracoscopic esophagectomy in the prone position

机译：胸腔镜食管切除术俯卧位

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Background: Minimally invasive esophageal surgery has arisen in an attempt to reduce the significant complications associated with esophagectomy. Despite proposed technical and physiological advantages, the prone position technique has not been widely adopted. This article reviews the current status of prone thoracoscopic esophagectomy. Methods: A systematic literature search was performed to identify all published clinical studies related to prone esophagectomy. Medline, EMBASE and Google Scholar were searched using the keywords "prone", "thoracoscopic", and " esophagectomy" to identify articles published between January 1994 and September 2010. A critical review of these studies is given, and where appropriate the technique is compared to the more traditional minimally invasive technique utilising the left lateral decubitus position. Results: Twelve articles reporting the outcomes following prone thoracoscopic oesophagectomy were tabulated. These studies were all non-randomised single-centre prospective or retrospective studies of which four compared the technique to traditional minimally invasive surgery. Although prone esophagectomy is demonstrated as being both feasible and safe, there is no convincing evidence that it is superior to other forms of esophageal surgery. Most authors comment that the prone position is associated with superior surgical ergonomics and theoretically offers a number of physiological benefits Conclusion: The ideal approach within minimally invasive esophageal surgery continues to be a subject of debate since no single method has produced outstanding results. Further clinical studies are required to see whether ergonomic advantages of the prone position can be translated into improved patient outcomes.
机译：背景：为了减少与食管切除术相关的重大并发症，出现了微创食管手术。尽管提出了技术和生理上的优势，俯卧位技术尚未得到广泛采用。本文回顾了俯卧胸腔镜食管切除术的现状。方法：进行系统的文献检索，以鉴定所有与俯卧食管切除术相关的已发表临床研究。使用关键词“俯卧”，“胸腔镜”和“食管切除术”搜索Medline，EMBASE和Google Scholar，以识别1994年1月至2010年9月之间发表的文章。对这些研究进行了严格审查，并在适当情况下比较了该技术转向更传统的利用左侧卧位的微创技术。结果：12篇报道俯卧胸腔镜食管切除术后结果的文章列表。这些研究都是非随机的单中心前瞻性或回顾性研究，其中有四项将这项技术与传统的微创手术进行了比较。尽管已证明俯卧食管切除术既可行又安全，但没有令人信服的证据表明它优于其他形式的食管手术。大多数作者认为，俯卧位与优越的人体工程学相关联，并且在理论上具有许多生理益处。结论：由于没有一种方法能产生出色的结果，因此微创食管手术中理想的方法仍然是一个争论的话题。需要进一步的临床研究以了解俯卧位的人体工程学优势是否可以转化为改善的患者预后。

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