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ID 52407
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Author
Maeda, Naoaki
Katsube, Ryoichi
Tanabe, Shunsuke Kaken ID
Ohara, Toshiaki
Sakurama, Kazufumi
Abstract
Thoracoscopic esophagectomy in the prone position (TEPP) might enable solo-surgery in cases requiring resection of the esophagus and the surrounding lymph nodes due to the associated advantages of good exposure of the surgical field and ergonomic considerations for the surgeon. However, no one approach can be for all patients requiring extensive lymphadenectomy. We recently developed an assistant-based procedure to standardize exposure of the surgical field. Patients were divided into 1 of 2 groups:a pre-standardization group (n=37) and a post-standardization group (n=28). The thoracoscopic operative time was significantly shorter (p=0.0037) in the post-standardization group (n=28; 267±31min) than in the pre-standardization group (n=37;301±53min). Further, learning curve analysis using the moving average method showed stabilization of the thoracoscopic operative time after the standardization. No significant differences were found in the number of mediastinal lymph nodes dissected or intraoperative blood loss between the 2 groups. There were also no significant differences in the complication rate. Assistant-based surgery and standardization of the procedure resulted in a well-exposed and safe surgical field. TEPP decreased the operative time, even in patients requiring extensive lymphadenectomy.
Keywords
thoracoscopic esophagectomy
prone position
standardization
Amo Type
Original Article
Published Date
2014-04
Publication Title
Acta Medica Okayama
Volume
volume68
Issue
issue2
Publisher
Okayama University Medical School
Start Page
111
End Page
117
ISSN
0386-300X
NCID
AA00508441
Content Type
Journal Article
language
英語
Copyright Holders
CopyrightⒸ 2014 by Okayama University Medical School
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publisher
Refereed
True
PubMed ID
Web of Science KeyUT