Effect of Esophagus Position on Surgical Difficulty and Postoperative Morbidities After Thoracoscopic Esophagectomy

Naoya Yoshida, Yoshifumi Baba, Hironobu Shigaki, Shinya Shiraishi, Kazuto Harada, Masayuki Watanabe, Masaaki Iwatsuki, Junji Kurashige, Yasuo Sakamoto, Yuji Miyamoto, Takatsugu Ishimoto, Keisuke Kosumi, Ryuma Tokunaga, Yasuyuki Yamashita, Hideo Baba

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

The objective include thoracoscopic esophagectomy for the deep-seated (left-sided) esophagus has several technical difficulties, which may affects the intraoperative or postoperative outcomes. However, no previous studies have focused on the correlation between the position of the esophagus and short-term outcome after thoracoscopic esophagectomy. Of 470 esophagectomies between April 2005 and April 2015 in Kumamoto University Hospital, 112 patients who underwent thoracoscopic esophagectomy for esophageal cancer were examined. The position of the esophagus was divided into 2 types: deep-seated esophagus or another type based on computed tomographic images in the supine position. In results, the deep-seated esophagus was associated with a longer operation time in the thorax and high incidence of severe morbidity of Clavien-Dindo classification ≥IIIb, pneumonia, and any pulmonary morbidity. The deep-seated esophagus was also an independent risk factor for severe morbidity (hazard ratio [HR] = 5.37, 95% CI: 1.307-22.03; P = 0.020), pneumonia (HR = 9.23, 95% CI: 2.150-39.60; P = 0.003), and any pulmonary morbidity (HR = 10.3, 95% CI: 2.714-38.78; P < 0.001). In conclusion, the position of the esophagus had a strong influence on the difficulty of thoracoscopic esophagectomy and the incidence of postoperative morbidities. Surgeons would be well advised to keep a careful watch perioperatively for patients with a deep-seated esophagus.

Original languageEnglish
Pages (from-to)172-179
Number of pages8
JournalSeminars in Thoracic and Cardiovascular Surgery
Volume28
Issue number1
DOIs
Publication statusPublished - Feb 1 2016

Fingerprint

Esophagectomy
Esophagus
Morbidity
Pneumonia
Lung
Supine Position
Incidence
Esophageal Neoplasms
Thorax

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Effect of Esophagus Position on Surgical Difficulty and Postoperative Morbidities After Thoracoscopic Esophagectomy. / Yoshida, Naoya; Baba, Yoshifumi; Shigaki, Hironobu; Shiraishi, Shinya; Harada, Kazuto; Watanabe, Masayuki; Iwatsuki, Masaaki; Kurashige, Junji; Sakamoto, Yasuo; Miyamoto, Yuji; Ishimoto, Takatsugu; Kosumi, Keisuke; Tokunaga, Ryuma; Yamashita, Yasuyuki; Baba, Hideo.

In: Seminars in Thoracic and Cardiovascular Surgery, Vol. 28, No. 1, 01.02.2016, p. 172-179.

Research output: Contribution to journalArticle

Yoshida, N, Baba, Y, Shigaki, H, Shiraishi, S, Harada, K, Watanabe, M, Iwatsuki, M, Kurashige, J, Sakamoto, Y, Miyamoto, Y, Ishimoto, T, Kosumi, K, Tokunaga, R, Yamashita, Y & Baba, H 2016, 'Effect of Esophagus Position on Surgical Difficulty and Postoperative Morbidities After Thoracoscopic Esophagectomy', Seminars in Thoracic and Cardiovascular Surgery, vol. 28, no. 1, pp. 172-179. https://doi.org/10.1053/j.semtcvs.2015.12.002
Yoshida, Naoya ; Baba, Yoshifumi ; Shigaki, Hironobu ; Shiraishi, Shinya ; Harada, Kazuto ; Watanabe, Masayuki ; Iwatsuki, Masaaki ; Kurashige, Junji ; Sakamoto, Yasuo ; Miyamoto, Yuji ; Ishimoto, Takatsugu ; Kosumi, Keisuke ; Tokunaga, Ryuma ; Yamashita, Yasuyuki ; Baba, Hideo. / Effect of Esophagus Position on Surgical Difficulty and Postoperative Morbidities After Thoracoscopic Esophagectomy. In: Seminars in Thoracic and Cardiovascular Surgery. 2016 ; Vol. 28, No. 1. pp. 172-179.
@article{778ffd026c474a9aa587e4126fcca52d,
title = "Effect of Esophagus Position on Surgical Difficulty and Postoperative Morbidities After Thoracoscopic Esophagectomy",
abstract = "The objective include thoracoscopic esophagectomy for the deep-seated (left-sided) esophagus has several technical difficulties, which may affects the intraoperative or postoperative outcomes. However, no previous studies have focused on the correlation between the position of the esophagus and short-term outcome after thoracoscopic esophagectomy. Of 470 esophagectomies between April 2005 and April 2015 in Kumamoto University Hospital, 112 patients who underwent thoracoscopic esophagectomy for esophageal cancer were examined. The position of the esophagus was divided into 2 types: deep-seated esophagus or another type based on computed tomographic images in the supine position. In results, the deep-seated esophagus was associated with a longer operation time in the thorax and high incidence of severe morbidity of Clavien-Dindo classification ≥IIIb, pneumonia, and any pulmonary morbidity. The deep-seated esophagus was also an independent risk factor for severe morbidity (hazard ratio [HR] = 5.37, 95{\%} CI: 1.307-22.03; P = 0.020), pneumonia (HR = 9.23, 95{\%} CI: 2.150-39.60; P = 0.003), and any pulmonary morbidity (HR = 10.3, 95{\%} CI: 2.714-38.78; P < 0.001). In conclusion, the position of the esophagus had a strong influence on the difficulty of thoracoscopic esophagectomy and the incidence of postoperative morbidities. Surgeons would be well advised to keep a careful watch perioperatively for patients with a deep-seated esophagus.",
author = "Naoya Yoshida and Yoshifumi Baba and Hironobu Shigaki and Shinya Shiraishi and Kazuto Harada and Masayuki Watanabe and Masaaki Iwatsuki and Junji Kurashige and Yasuo Sakamoto and Yuji Miyamoto and Takatsugu Ishimoto and Keisuke Kosumi and Ryuma Tokunaga and Yasuyuki Yamashita and Hideo Baba",
year = "2016",
month = "2",
day = "1",
doi = "10.1053/j.semtcvs.2015.12.002",
language = "English",
volume = "28",
pages = "172--179",
journal = "Seminars in Thoracic and Cardiovascular Surgery",
issn = "1043-0679",
publisher = "W.B. Saunders Ltd",
number = "1",

}

TY - JOUR

T1 - Effect of Esophagus Position on Surgical Difficulty and Postoperative Morbidities After Thoracoscopic Esophagectomy

AU - Yoshida, Naoya

AU - Baba, Yoshifumi

AU - Shigaki, Hironobu

AU - Shiraishi, Shinya

AU - Harada, Kazuto

AU - Watanabe, Masayuki

AU - Iwatsuki, Masaaki

AU - Kurashige, Junji

AU - Sakamoto, Yasuo

AU - Miyamoto, Yuji

AU - Ishimoto, Takatsugu

AU - Kosumi, Keisuke

AU - Tokunaga, Ryuma

AU - Yamashita, Yasuyuki

AU - Baba, Hideo

PY - 2016/2/1

Y1 - 2016/2/1

N2 - The objective include thoracoscopic esophagectomy for the deep-seated (left-sided) esophagus has several technical difficulties, which may affects the intraoperative or postoperative outcomes. However, no previous studies have focused on the correlation between the position of the esophagus and short-term outcome after thoracoscopic esophagectomy. Of 470 esophagectomies between April 2005 and April 2015 in Kumamoto University Hospital, 112 patients who underwent thoracoscopic esophagectomy for esophageal cancer were examined. The position of the esophagus was divided into 2 types: deep-seated esophagus or another type based on computed tomographic images in the supine position. In results, the deep-seated esophagus was associated with a longer operation time in the thorax and high incidence of severe morbidity of Clavien-Dindo classification ≥IIIb, pneumonia, and any pulmonary morbidity. The deep-seated esophagus was also an independent risk factor for severe morbidity (hazard ratio [HR] = 5.37, 95% CI: 1.307-22.03; P = 0.020), pneumonia (HR = 9.23, 95% CI: 2.150-39.60; P = 0.003), and any pulmonary morbidity (HR = 10.3, 95% CI: 2.714-38.78; P < 0.001). In conclusion, the position of the esophagus had a strong influence on the difficulty of thoracoscopic esophagectomy and the incidence of postoperative morbidities. Surgeons would be well advised to keep a careful watch perioperatively for patients with a deep-seated esophagus.

AB - The objective include thoracoscopic esophagectomy for the deep-seated (left-sided) esophagus has several technical difficulties, which may affects the intraoperative or postoperative outcomes. However, no previous studies have focused on the correlation between the position of the esophagus and short-term outcome after thoracoscopic esophagectomy. Of 470 esophagectomies between April 2005 and April 2015 in Kumamoto University Hospital, 112 patients who underwent thoracoscopic esophagectomy for esophageal cancer were examined. The position of the esophagus was divided into 2 types: deep-seated esophagus or another type based on computed tomographic images in the supine position. In results, the deep-seated esophagus was associated with a longer operation time in the thorax and high incidence of severe morbidity of Clavien-Dindo classification ≥IIIb, pneumonia, and any pulmonary morbidity. The deep-seated esophagus was also an independent risk factor for severe morbidity (hazard ratio [HR] = 5.37, 95% CI: 1.307-22.03; P = 0.020), pneumonia (HR = 9.23, 95% CI: 2.150-39.60; P = 0.003), and any pulmonary morbidity (HR = 10.3, 95% CI: 2.714-38.78; P < 0.001). In conclusion, the position of the esophagus had a strong influence on the difficulty of thoracoscopic esophagectomy and the incidence of postoperative morbidities. Surgeons would be well advised to keep a careful watch perioperatively for patients with a deep-seated esophagus.

UR - http://www.scopus.com/inward/record.url?scp=84961783924&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84961783924&partnerID=8YFLogxK

U2 - 10.1053/j.semtcvs.2015.12.002

DO - 10.1053/j.semtcvs.2015.12.002

M3 - Article

AN - SCOPUS:84961783924

VL - 28

SP - 172

EP - 179

JO - Seminars in Thoracic and Cardiovascular Surgery

JF - Seminars in Thoracic and Cardiovascular Surgery

SN - 1043-0679

IS - 1

ER -