| Objective:For patients with esophageal cancer, thoracscopic Mckeown esophagectomy is the most effect minimally invasive approach. Recently, consist with the aim of minimally invasive surgery, thoracscopic esophagectomy in prone position was regaining more attention, whether it is beneficial remains uncertain. In this study, we compared the short-term outcome in patients with esophageal cancer after thoracscopic esophagectomy in prone position or in left lateral decubitus position.Method:A total of 67 patients who underwent thoracscopic Mckeown esophagectomy by the same surgical group from July 2013 to February 2014 were enrolled in this randomized controlled trial. Thirty-five patients followed thoracscopic esophagectomy in prone position (PP group) and 32 patients followed thoracscopic esophagectomy in left lateral decubitus position (LDP group). The operative data, morbidity, mortality, systematic inflammatory response parameters and postoperative oxygenation index were applied to assess the short-term outcome of the patients after operation.Result:The clinical data and physiological parameters were comparable, and no significant difference was found in hospital stay, morbidity and mortality between the two groups. Compared with LDP group, PP group has shorter operative time of thoracic part (68±22 min vs.87 ±24 min,p=0.000), more retrieved lymph nodes in thoracic part (13.3 ±6.1 vs.9.2±6.5, P=0.010), more retrieved mediastianl nodal stations (2.8±1.1 vs.2.2±0.8,p=0.014), and lower hospital cost (74991.0± 16598.6Y vs.5065.1±14377.9￥, P=0.010). The significant difference of reduction of oxygenation index after surgery was also found in PP group than LDP group.Conclusions:Both surgical approaches are safe and effective. Thoracscopic esophagectomy in prone position shows the benefit on the safety, efficiency and postoperative oxygenation index compared with that in left lateral decubitus position. |
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