title: Thoracoscopic enucleation of esophageal gastrointestinal stromal tumor using prone positioning in a patient with severe chronic obstructive lung disease.
abstract: Abstract Chronic obstructive lung disease (COPD) is a high-risk factor for pulmonary complications in esophageal surgery. We reported a case of esophageal gastrointestinal stromal tumor (GIST) in a patient with severe COPD. Upper gastrointestinal endoscopy and computed tomography revealed a 3×2-cm submucosal tumor at the lower esophagus, and positron emission tomography showed a hypermetabolic mass (SUV(max)=5.6). Forced expiratory volume in 1 second (FEV(1)) was 33.0% of predicted and FEV(1)/forced vital capacity ratio was 40.7%. Taking the patient's lung function into account, we performed a thoracoscopic enucleation for the esophageal GIST while the patient was in a prone position. The postoperative course was uneventful and no significant change was observed in the patient's respiratory condition. Performing thoracoscopic surgery on COPD patients in a prone position is a good therapeutic alternative for reducing the occurrence of pulmonary complications.
authors.affiliation: Department of Surgery, Hokushin General Hospital, Nagano, Japan. h-yamada.srg2@tmd.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamada
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shinohara
authors.forename: Kenji
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Kaori
authors.initials: K
authors.lastname: Takasu
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Fujimori
authors.forename: Kiyohumi
authors.initials: K
authors.lastname: Yamagishi
mesh_terms: D000368:Aged; D004938:Esophageal Neoplasms / Q000150:complications* / Q000601:surgery*; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000150:complications* / Q000601:surgery*; D006801:Humans; D056888:Patient Positioning / Q000379:methods*; D016684:Prone Position; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012720:Severity of Illness Index; D013906:Thoracoscopy