TY - JOUR
T1 - Esophageal Position Affects Short-Term Outcomes After Minimally Invasive Esophagectomy
T2 - A Retrospective Multicenter Study
AU - Uchihara, Tomoyuki
AU - Yoshida, Naoya
AU - Baba, Yoshifumi
AU - Nakashima, Yuichiro
AU - Kimura, Yasue
AU - Saeki, Hiroshi
AU - Takeno, Shinsuke
AU - Sadanaga, Noriaki
AU - Ikebe, Masahiko
AU - Morita, Masaru
AU - Toh, Yasushi
AU - Nanashima, Atsushi
AU - Maehara, Yoshihiko
AU - Baba, Hideo
N1 - Publisher Copyright:
© 2019, Société Internationale de Chirurgie.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Background: Anatomical esophageal position may affect the short-term outcomes after minimally invasive esophagectomy (MIE). A previous single-institutional retrospective study suggested that the presence of a left-sided esophagus (LSE) made MIE more difficult and increased the incidence of postoperative complications. Methods: The current study was a multicenter retrospective study of 303 patients with esophageal cancer who underwent MIE at six esophageal cancer high-volume centers in Kyushu, Japan, between April 2011 and August 2016. The patients were divided into the LSE (66 patients) and non-LSE groups (237 patients) based on the esophageal position on computed tomography images obtained with the patients in the supine position. Results: Univariate analysis showed that patients with LSE were significantly older than those with non-LSE (69 ± 8 vs. 65 ± 9 years; P = 0.002), had a significantly greater incidence of cardiovascular comorbidity (65.2% vs. 47.7%; P = 0.013), and a significantly longer operating time (612 ± 112 vs. 579 ± 102 min; P = 0.025). Logistic regression analysis verified that LSE was an independent risk factor for the incidence of pneumonia (odds ratio 3.3, 95% confidence interval 1.254–8.695; P = 0.016). Conclusions: The presence of a LSE can increase the procedural difficulty of MIE and the incidence of morbidity after MIE. Thus, careful attention must be paid to anatomical esophageal position before performing MIE.
AB - Background: Anatomical esophageal position may affect the short-term outcomes after minimally invasive esophagectomy (MIE). A previous single-institutional retrospective study suggested that the presence of a left-sided esophagus (LSE) made MIE more difficult and increased the incidence of postoperative complications. Methods: The current study was a multicenter retrospective study of 303 patients with esophageal cancer who underwent MIE at six esophageal cancer high-volume centers in Kyushu, Japan, between April 2011 and August 2016. The patients were divided into the LSE (66 patients) and non-LSE groups (237 patients) based on the esophageal position on computed tomography images obtained with the patients in the supine position. Results: Univariate analysis showed that patients with LSE were significantly older than those with non-LSE (69 ± 8 vs. 65 ± 9 years; P = 0.002), had a significantly greater incidence of cardiovascular comorbidity (65.2% vs. 47.7%; P = 0.013), and a significantly longer operating time (612 ± 112 vs. 579 ± 102 min; P = 0.025). Logistic regression analysis verified that LSE was an independent risk factor for the incidence of pneumonia (odds ratio 3.3, 95% confidence interval 1.254–8.695; P = 0.016). Conclusions: The presence of a LSE can increase the procedural difficulty of MIE and the incidence of morbidity after MIE. Thus, careful attention must be paid to anatomical esophageal position before performing MIE.
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U2 - 10.1007/s00268-019-05273-8
DO - 10.1007/s00268-019-05273-8
M3 - Article
C2 - 31701157
AN - SCOPUS:85074867746
VL - 44
SP - 831
EP - 837
JO - World Journal of Surgery
JF - World Journal of Surgery
SN - 0364-2313
IS - 3
ER -