title: Thoracoscopic oesophageal mobilization during thoracolaparoscopy three-stage oesophagectomy: a comparison of lateral decubitus versus semiprone positions.
abstract: OBJECTIVE
  The aim of this study is to compare thoracoscopic mobilization of the oesophagus in the lateral decubitus position and the semiprone position and to identify potential differences between the two techniques.
  
  
  METHODS
  A retrospective review of a prospectively maintained oesophagectomy database identified 150 patients undergoing combined thoracoscopic and laparoscopic oesophagectomy (TLO). Of these, 90 cases underwent thoracoscopic oesophageal mobilization in the left lateral decubitus position. The remaining 60 cases underwent thoracoscopic oesophageal mobilization in the semiprone position.
  
  
  RESULTS
  There were no differences in the clinicopathological factors and tumour characteristics between the two groups. There was no significant difference in the blood loss, operation time, the incidence of conversion, length of hospital stay or in the number of retrieved mediastinal and abdominal nodes between the two groups. There was no significant difference with regard to the incidence of respiratory complications, anastomotic leaks, vocal cord palsy, chylothorax, delayed gastric emptying, arrhythmia and intestinal obstruction between the two groups.
  
  
  CONCLUSIONS
  The semiprone and lateral decubitus positions each have their inherent advantages and disadvantages. Our initial experience confirmed that while the semiprone position is associated with superior surgical ergonomics and better exposure of the posterior mediastinum, there is no convincing evidence that semiprone thoracoscopic oesophagectomy is superior to the left lateral decubitus positioning with respect to the major surgical outcomes and oncological clearance.
authors.affiliation: Department of Thoracic Surgery, Affiliated Union Hospital of Fujian Medical University, Fuzhou, China.
authors.forename: Jiangbo
authors.initials: J
authors.lastname: Lin
authors.forename: Mingqiang
authors.initials: M
authors.lastname: Kang
authors.forename: Chun
authors.initials: C
authors.lastname: Chen
authors.forename: Ruobai
authors.initials: R
authors.lastname: Lin
mesh_terms: D000368:Aged; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D016684:Prone Position; D012189:Retrospective Studies; D013906:Thoracoscopy / Q000009:adverse effects; D016896:Treatment Outcome
keywords: Oesophageal cancer; Oesophageal surgery; Thoracoscopy