Usefulness of prone-position computed tomography as preoperative simulation prior to thoracoscopic esophagectomy for thoracic esophageal cancer

Esophagus ◽  
2021 ◽  
Author(s):  
Tadashi Higuchi ◽  
Soji Ozawa ◽  
Kazuo Koyanagi ◽  
Yamato Ninomiya ◽  
Kentaro Yatabe ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Esophageal Cancer ◽  
Prone Position ◽  
Thoracoscopic Esophagectomy ◽  
Thoracic Esophageal Cancer ◽  
Preoperative Simulation

scholarly journals Thoracoscopic esophagectomy in the prone position for esophageal cancer patients with pectus excavatum: a report of two cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Tomoya Tsukada ◽  
Yuto Kitano ◽  
Yuya Sugimoto ◽  
Masahide Kaji
Keyword(s):  
Computed Tomography ◽  
Esophageal Cancer ◽  
Prone Position ◽  
Pectus Excavatum ◽  
Thoracoscopic Esophagectomy ◽  
Field Of View ◽  
Case Presentation ◽  
Haller Index ◽  
Surgical Field ◽  
Surgical Option

Abstract Background Pectus excavatum is a common thoracic deformity that can be encountered during thoracoscopic esophagectomy. Here, we report two cases of esophageal cancer complicated by pectus excavatum that were treated with thoracoscopic esophagectomy with the patients in the prone position. Case presentation The first patient was a 64-year-old male diagnosed with esophageal cancer (cT3N0M0, Haller index 8.5) and underwent radical thoracoscopic esophagectomy in the prone position following neoadjuvant chemotherapy. The second patient was a 67-year-old male diagnosed with esophageal cancer (cT1bN0M0, Haller index 4.3), and the same procedure was performed in this patient. In cases of patients with a high Haller index, where securing the surgical field is difficult, preoperative computed tomography in the prone position can help surgeons to understand the mediastinal field of view and is safe. Conclusions Radical thoracoscopic esophagectomy in the prone position may be a surgical option in patients with pectus excavatum.

668 USEFULNESS OF PRONE-POSITION COMPUTED TOMOGRAPHY AS PREOPERATIVE SIMULATION OF THORACOSCOPIC ESOPHAGECTOMY FOR THORACIC ESOPHAGEAL CANCER

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Tadashi Higuchi ◽  
Kazuo Koyanagi ◽  
Yamato Ninomiya ◽  
Kentaro Yatabe ◽  
Miho Yamamoto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Esophageal Cancer ◽  
Prone Position ◽  
Surgical Outcomes ◽  
Operation Time ◽  
Ct Imaging ◽  
University Hospital ◽  
Postoperative Pneumonia ◽  
Thoracic Esophageal Cancer ◽  
Invasive Esophagectomy

Abstract   The study aimed to evaluate the usefulness of prone-position computed tomography (CT) for predicting relevant thoracic procedure outcomes in minimally invasive esophagectomy (MIE) for thoracic esophageal cancer. Methods A total of 59 patients underwent esophagectomy between May 2019 and December 2020 in Tokai University Hospital. Preoperative CT imaging was conducted with the patient in both the supine and prone positions, and the magnitude of change in the intramediastinal space was calculated. In the 56 patients (94.9%) who had undergone MIE, the effects of such a difference on the surgical outcomes were analyzed. Results A significant correlation of the magnitude of change in VE (distance between ventral aspect of vertebral body and the midpoint of esophagus) with the surgical outcome was revealed in the 17 patients (30.4%) in whom the magnitude of change in VE was over the 75th percentile. That is, in this subgroup, VE showed a negative correlation with the thoracic operation time (p = 0.01) and blood loss during the thoracic procedure (p = 0.01). Multivariate analysis identified a magnitude of change in VE □9 mm as an independent risk factor for postoperative pneumonia. Conclusion This study indicates that preoperative prone-position CT imaging is useful for predicting the level of ease or difficulty of securing an adequate operative field, surgical outcomes, and the risk of postoperative pneumonia in MIE.

PS02.006: OPERATIVE INDICATION AND PROCEDURES OF THORACOSCOPIC ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 121-121
Author(s):  
Takashi Kamei
Keyword(s):  
Esophageal Cancer ◽  
Survival Rate ◽  
Prone Position ◽  
Neoadjuvant Treatment ◽  
Thoracoscopic Esophagectomy ◽  
Operative Indication ◽  
Definitive Chemoradiotherapy ◽  
Long Term Outcome ◽  
Thoracoscopic Approach ◽  
Left Lateral Decubitus Position

Abstract Background Thoracoscopic esophagectomy has been performed for two decades and becomes widely spread. We evaluate our cases who undergone the thoracoscopic esophagectomy and consider the future prospective of this operation. Methods 702 patients who received thoracoscopic esophagectomy in our institute from March 1995 to October 2017 were enrolled and studied retrospectively. Operative indication is an all of the clinically resectable cases including with a neoadjuvant treatment or definitive chemoradiotherapy before surgery. Overall survival rate of the patients with thoracoscopic approach and with thoracotomy until 2001 was analyzed. Long term outcome of the patients with thoracoscopic esophagectomy was compared to the result from comprehensive registry of esophageal cancer in Japan. Short term results of the perioperative parameters were analyzed between left lateral decubitus position and prone position. Results There was no significant differences of the survival rate between thoracoscopic group and thoracotomy group based on pathological stage. 5 year survival without neoadjuvant treatment was 88.9% (pStageI), 71.5%(pStageIIA), 68.1%(pStageIIB), 40.9%(pStageIII), respectively.5 year survival rate of cStageII and III with neoadjuvant chemotherapy was 65.7% and 5 year survival rate of the salvage esophagectomy after failure of definitive chemoradiotherapy was 31.4%. Every outcomes are as good as any reported results in esophagectomy. In the comparison of the lateral position with the prone position, total blood loss was significantly lower in prone position. Inflammatory response after surgery was improved more rapidly in prone group, therefore, prone position is recommended as a minimally invasive procedure for thoracoscopic esophagectomy. Conclusion Thoracoscopic esophagectomy will develop further as a standard operation for esophageal cancer. However, from the point of view of the safety, an appropriate educational systems of this advanced procedure should build. Disclosure All authors have declared no conflicts of interest.

VS01.04: RELIABLE SURGICAL TECHNIQUES FOR LYMPHADENECTOMY ALONG THE LEFT RECURRENT LARYNGEAL NERVE DURING THORACOSCOPIC ESOPHAGECTOMY IN THE PRONE POSITION

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 44-44
Author(s):  
Taro Oshikiri ◽  
Tetsu Nakamura ◽  
Hiroshi Hasegawa ◽  
Masashi Yamamoto ◽  
Shingo Kanaji ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Recurrent Laryngeal Nerve ◽  
Prone Position ◽  
Conflicts Of Interest ◽  
Surgical Techniques ◽  
Laryngeal Nerve ◽  
Thoracoscopic Esophagectomy ◽  
Left Recurrent Laryngeal Nerve

Abstract Description Background Lymphadenectomy along the left recurrent laryngeal nerve (RLN) in esophageal cancer is important for disease control but requires advanced dissection skills. Complete dissection of the lymph nodes along the left RLN in a safe manner is important. We demonstrate the reliable method for lymphadenectomy along the left RLN during thoracoscopic esophagectomy in the prone position (TEP). Methods This procedure is performed for all of resectable thoracic esophageal cancers. The essence of this method is to recognize the lateral pedicle as a two-dimensional membrane that inclu replicatedes the left RLN, lymph nodes around the nerve, and primary esophageal arteries. By drawing the proximal portion of the divided esophagus and the lateral pedicle, identification and reliable cutting of the primary esophageal arteries and distinguishing the left RLN from the lymph nodes are simplified. Results We performed 46 TEPs for esophageal cancer using this method with no conversion to an open procedure in 2015 at Kobe University. No intraoperative morbidity related to the left RLN was observed. The mean number of harvested lymph nodes along the left RLN was 6.9 ± 4.2. Left RLN palsy greater than Clavien-Dindo classification grade II occurred in 4 patients (8%), all of them were reversible. The incidence of lymph node metastasis along the left RLN was 22%. Conclusion Our method for lymphadenectomy along the left RLN during TEP is safe and reliable. It has a low incidence of left RLN palsy and provides sufficient lymph node dissection along the left RLN. Disclosure All authors have declared no conflicts of interest.

Outcomes of thoracoscopic esophagectomy in prone position with laparoscopic gastric mobilization for esophageal cancer

2016 ◽  
Vol 401 (5) ◽  
pp. 699-705 ◽  
Author(s):  
Hiroyuki Kitagawa ◽  
Tsutomu Namikawa ◽  
Masaya Munekage ◽  
Kazune Fujisawa ◽  
Eri Munekgae ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Prone Position ◽  
Thoracoscopic Esophagectomy
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