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胸腔镜食管切除术俯卧位与侧卧位短期结局的比较

Comparison of short-term outcomes between prone and lateral decubitus positions for thoracoscopic esophagectomy.

作者信息

Teshima Jin, Miyata Go, Kamei Takashi, Nakano Toru, Abe Shigeo, Katsura Kazunori, Taniyama Yusuke, Sakurai Tadashi, Hikage Makoto, Nakamura Takanobu, Takaya Kai, Zuguchi Masashi, Okamoto Hiroshi, Youhei Ozawa, Ohuchi Noriaki

机构信息

Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai-shi, Miyagi-ken, 980-8575, Japan,

出版信息

Surg Endosc. 2015 Sep;29(9):2756-62. doi: 10.1007/s00464-014-4003-y. Epub 2014 Dec 6.

Abstract

BACKGROUND

Prone thoracoscopic esophagectomy was introduced at our institution from 2012. This study describes our experiences of the main differences between thoracoscopic esophagectomy in the prone and traditional left lateral decubitus positions together with an analysis of the short-term surgical outcomes.

METHOD

In total, 87 patients undergoing thoracoscopic esophagectomy between January 2012 and October 2013 at Tohoku University Hospital were enrolled; of these, 54 and 33 patients were operated in the prone (Group P) and lateral decubitus (Group L) positions, respectively.

RESULTS

The background of the patients was similar, and there was no in-hospital mortality. There were no significant differences between the groups in terms of whole surgical duration, thoracic duration, and number of dissected lymph nodes. Total blood loss and thoracic estimated blood loss were significantly lower in Group P than Group L. Furthermore, postoperative pulmonary complications, intensive care unit stay, and hospital stay were significantly lower in Group P.

CONCLUSION

Thoracoscopic esophagectomy in the prone position is feasible and safe. The prone position technique may be superior to conventional lateral decubitus position esophagectomy.

摘要

背景

我院自2012年开始开展俯卧位胸腔镜食管癌切除术。本研究描述了我们在俯卧位胸腔镜食管癌切除术与传统左侧卧位胸腔镜食管癌切除术之间的主要差异的经验,并分析了短期手术结果。

方法

2012年1月至2013年10月在东北大学医院接受胸腔镜食管癌切除术的87例患者纳入研究;其中,分别有54例和33例患者在俯卧位(P组)和侧卧位(L组)接受手术。

结果

两组患者的背景相似,均无院内死亡。两组在整个手术时长、胸部手术时长和清扫淋巴结数量方面无显著差异。P组的总失血量和胸部估计失血量均显著低于L组。此外,P组的术后肺部并发症、重症监护病房停留时间和住院时间均显著更低。

结论

俯卧位胸腔镜食管癌切除术是可行且安全的。俯卧位技术可能优于传统侧卧位食管癌切除术。

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