title: Minimally invasive esophagectomy with right bronchial occlusion under artificial pneumothorax.
abstract: OBJECTIVE
  To assess the safety and feasibility of minimally invasive esophagectomy and selected three-field lymphadenectomy with the right bronchial occlusion in left semi-prone position under artificial pneumothorax.
  
  
  METHODS
  Thoracoscopic-laparoscopic subtotal esophagectomy and selected three-field lymphadenectomy were performed in 166 patients with esophageal carcinoma by the right bronchial occlusion in left semi-prone position under artificial pneumothorax.
  
  
  RESULTS
  109 patients received two-field lymphadenectomy and 57 received three-field lymphadenectomy. The average operative time was 202.5 ± 21.3 min; the average thoracoscopic operative time was 98.4 ± 15.5 min. The average blood loss was 39.6 ± 4.2 ml, and no blood transfusion was needed during the surgery. The mean lymph node harvest was 28.4 ± 5.2 nodes. Hospital stay ranged from 7 to 95 days and the average was 11.3 days. The postoperative complication rate was 29.5%, and the mortality rate was 1.2%.
  
  
  CONCLUSIONS
  It is feasible and safe to perform thoracoscopic-laparoscopic subtotal esophagectomy and selected three-field lymphadenectomy with the right bronchial occlusion in left semi-prone position under artificial pneumothorax for esophageal carcinoma. The procedure shows advantages in improved visibility and accessibility of the surgical field, and better subsequent surgical outcomes.
authors.affiliation: Department of Cardiothoracic Surgery of Affiliated Third Hospital, University of Jianghan, Wuhan, People's Republic of China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.forename: RuiHua
authors.initials: R
authors.lastname: Duan
authors.forename: XiangFeng
authors.initials: X
authors.lastname: Xiao
authors.forename: Tiecheng
authors.initials: T
authors.lastname: Pan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D001980:Bronchi / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods* / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000401:mortality; D007902:Length of Stay; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011031:Pneumothorax, Artificial; D011183:Postoperative Complications / Q000453:epidemiology; D013906:Thoracoscopy / Q000401:mortality; D016896:Treatment Outcome