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首页> 外文期刊>Surgical Endoscopy >Thoracoscopic esophageal mobilization during minimally invasive esophagectomy: a head-to-head comparison of prone versus decubitus positions.
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Thoracoscopic esophageal mobilization during minimally invasive esophagectomy: a head-to-head comparison of prone versus decubitus positions.

机译：微创食管切除术中的胸腔镜食管动员：俯卧位与卧位位置的头对头比较。

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BACKGROUND: Minimally invasive esophagectomy (MIE) is being performed at an increasing number of institutions. The thoracoscopic portion is generally performed in the left lateral decubitus position. Recently there has been increasing interest in esophageal mobilization in the prone position and the potential benefits of this technique with regard to operative time, surgeon ergonomics, and operative exposure. We sought to objectively compare thoracoscopic mobilization of the esophagus in the left lateral decubitus position versus the prone position and identify potential differences between the two techniques. METHODS: A retrospective review of a prospectively maintained esophagectomy database identified 44 patients undergoing MIE during a 20-month period (June 2005-February 2007). Of these, 32 patients underwent thoracoscopic esophageal mobilization with cervical esophagogastric anastomosis. Eleven cases were performed in the left lateral decubitus position and 21 performed in the prone position. RESULTS: The patients were comparable in age, tumor stage, and fraction undergoing neoadjuvant therapy. There was no statistically significant difference between decubitus position and prone position with regard to number of lymph nodes procured (14.6 versus 15.5, p = 0.69), complications (6/11 versus 10/21, p = 1.0), length of stay (9 versus 10 days, p = 1.0), or intraoperative blood loss (85 versus 65 cc, p = 0.14). Thoracoscopic operative times were significantly shorter in the prone group than the decubitus group (86 versus 123 min, p = 0.0001). CONCLUSIONS: Prone thoracoscopic esophageal mobilization appears to be equivalent to decubitus thoracoscopic esophageal mobilization with respect to blood loss, number of lymph nodes dissected, and complications, but with a significant reduction in thoracoscopic surgical time.
机译：背景：越来越多的机构正在开展微创食管切除术（MIE）。胸腔镜检查部分通常在左侧卧位进行。最近，人们对俯卧位食管动员越来越感兴趣，并且该技术在手术时间，外科医生人体工程学和手术暴露方面具有潜在的优势。我们试图客观地比较胸腔镜在左侧卧位与俯卧位的食管动员情况，并确定两种技术之间的潜在差异。方法：对前瞻性维持的食管切除术数据库进行的回顾性研究确定了在20个月内（2005年6月至2007年2月）接受MIE治疗的44例患者。其中，有32例患者接受了胸腔镜食管动员并进行了宫颈食管胃吻合术。左侧卧位11例，俯卧位21例。结果：患者在年龄，肿瘤分期和接受新辅助治疗的比例方面具有可比性。就获得的淋巴结数目（14.6 vs 15.5，p = 0.69），并发症（6/11 vs 10/21，p = 1.0），住院时间（9）而言，卧位与俯卧位之间无统计学差异。对比10天，p = 1.0）或术中失血（85对比65 cc，p = 0.14）。俯卧组的胸腔镜手术时间明显少于褥疮组（86 vs 123 min，p = 0.0001）。结论：就失血量，解剖的淋巴结数目和并发症而言，俯卧的胸腔镜食管动员似乎等同于褥疮的胸腔镜食管动员，但显着减少了胸腔镜手术时间。

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