title: Outcomes of thoracoscopic esophagectomy in prone position with laparoscopic gastric mobilization for esophageal cancer.
abstract: OBJECTIVE
  The aim of this study was to evaluate the short- and long-term outcomes of thoracoscopic esophagectomy performed in the prone position (TSE-PP) followed by laparoscopic gastric mobilization (LGM) compared with open thoracotomy and LGM, for esophageal cancers.
  
  
  METHODS
  We reviewed the records of 105 consecutive patients who underwent esophagectomy with LGM for esophageal cancer at Kochi Medical School. Among the study patients, 60 patients underwent TSE-PP, while 45 underwent open thoracotomy (OPEN group). The perioperative outcomes of the two groups were compared.
  
  
  RESULTS
  Compared to the OPEN group, the TSE-PP group had lower blood loss (TSE-PP, 150 mL; OPEN, 430 mL; P < 0.001), longer operative time (TSE-PP, 609 min; OPEN, 570 min; P = 0.012), more lymph nodes dissected around the left recurrent laryngeal nerve (TSE-PP, 6; OPEN, 2; P < 0.001), and a shorter length of hospital stay (TSE-PP, 16.5 days; OPEN, 35 days; P < 0.001). The incidence of postoperative complications was similar in the two groups. Though the recurrence rate and overall survival were not significantly different in the two groups, the TSE-PP group had better overall survival rates than the OPEN group (P = 0.122).
  
  
  CONCLUSIONS
  Patients who underwent TSE-PP with LGM for esophageal cancers recovered earlier after surgery compared to those who underwent open thoracotomy with LGM.
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kitagawa
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi, Japan. tsutomun@kochi-u.ac.jp.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Namikawa
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Munekage
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi, Japan.
authors.forename: Kazune
authors.initials: K
authors.lastname: Fujisawa
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Munekgae
authors.affiliation: Department of Human Health and Medical Sciences, Kochi Medical School, Kochi, Japan.
authors.forename: Michiya
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D016684:Prone Position; D012189:Retrospective Studies; D013906:Thoracoscopy; D013908:Thoracotomy; D016896:Treatment Outcome
keywords: Esophageal cancer; Esophagectomy; Laparoscopic gastric mobilization; Prone position; Thoracoscopic esophagectomy