A comparison of perioperative short outcomes between different positions in thoraco-laparascopic esophagostomy for patients with esophageal cancer

Abstract

The goal othis study is to compare the short course out comes of thoraco-laparascopic esophagectomy in lateral decubitus,semiprone and prone positions. Materials and methods: In this clinical trial study 5۱ patients with esophageal cancer entered into the study and divided into three groups with prone,semiprone and lateral decubitus positions.the patients underwent minimally invasive esophagectomy.All the patients were operated by a thoracic surgeon.The study parameters including demoghraphic data and variants before surgery(age,sex,location of the tumor,histopathology,neoadjuvant therapy),during surgery(duration time of the surgery,blood loss volume,the probability of the change in to open technique),after surgery(mortality,morbidity,respiratory complications,esophago-gastric anastomosis leak,thoracic duct injury,hoarsness) all were collected.Respiratory complications included of body temperature above 38 c together with pneumonia or athelectasia.The above mentioned variants were compared between three groups of patients.

Results: The results of analysis of the parameters during surgery showed the least mean of the duration of the surgery and blood loss in patients operated in prone position. Most patients with cardiac arrhythmia were seen in prone position and cardiac infarction was seen in one patient at the same position. The least mean number of dissected lymph nodes were seen in prone position group and the most in lateral decubitus group. After surgery most pathologic reports indicated the tumor in stage 3,with only 6 patients in stage 2.time of surgery was shortest in semiprone position,the longest ICU admission time was seen lateral decubitus position.The shortest mean time of chest tube drainage was in semiprone position and this was equal in prone and lateral decubitus positions.Thoracic duct injury was seen in two patients,one in prone and one in lateral decubitus position.Other complications including pulmonary embolization,pneumonia,fever and anastomosis leak were seen mostly in prone position.There was no statistically meaningfull difference in parameters of before,during and after surgery.