| Added by | standudu |
|---|---|
| Group name | EquipeAT |
| Item Type | Journal Article |
| Title | Thoracoscopy in prone position with two-lung ventilation compared to conventional thoracotomy during Ivor Lewis procedure: a multicenter case-control study |
| Creator | Souche et al. |
| Author | R. Souche |
| Author | M. Nayeri |
| Author | R. Chati |
| Author | E. Huet |
| Author | I. Donici |
| Author | J. J. Tuech |
| Author | F. Borie |
| Author | M. Prudhomme |
| Author | S. Jaber |
| Author | J. M. Fabre |
| Abstract | BACKGROUND: Intraoperative management based on thoracoscopy, prone position and two-lung ventilation could decrease the rate of postoperative pulmonary complications after esophagectomy. The aim of this study was to compare this multifaceted approach (MIE-PP) and conventional thoracotomy for Ivor Lewis procedure after a systematic laparoscopic dissection. METHODS: Data from 137 consecutive patients undergoing Ivor Lewis procedures between 2010 and 2017 at two tertiary centers was analyzed retrospectively. The outcomes of patients who underwent MIE-PP (n?=?58; surgeons group 1) were compared with those of patients undergoing conventional approach (n?=?79; surgeons group 2). Our primary outcome was major postoperative pulmonary complications. Our main secondary outcomes were anastomotic leak, quality of resection and mortality. RESULTS: Female patients were more prevalent in the MIE-PP group (p?=?0.002). Other patient characteristics, cTNM staging and neoadjuvant treatment rate were not different between groups. Major postoperative pulmonary complications were significantly lower in the MIE-PP group compared to Conventional group (24 vs. 44%; p?=?0.014). Anastomotic leak occurred in 31 versus 18% in MIE-PP group and Conventional groups, respectively (p?=?0.103). Complete resection rate (98 vs. 95%; p?=?0.303) and mean number of harvested lymph nodes (16 (4-40) vs. 18 (3-37); p?=?0.072) were similar between the two groups. Postoperative mortality rates were 0 versus 2% at day 30 (p?=?0.508) and 0 versus 7.6% at day 90 (p?=?0.038). CONCLUSION: Short-term outcomes of minimally invasive Ivor Lewis using thoracoscopy, prone position and two-lung ventilation are at least equivalent to the hybrid approach. Anastomotic leak after MIE-PP remains a major concern. |
| Publication | Surgical Endoscopy |
| Date | Mar 13, 2019 |
| Journal Abbr | Surg Endosc |
| Language | eng |
| DOI | 10.1007/s00464-019-06742-w |
| ISSN | 1432-2218 |
| Short Title | Thoracoscopy in prone position with two-lung ventilation compared to conventional thoracotomy during Ivor Lewis procedure |
| Library Catalog | PubMed |
| Extra | PMID: 30868323 |
| Tags | clinic, Esophageal cancer, Ivor Lewis, Minimally invasive, Prone position, Pulmonary complications |
| Date Added | 2019/05/29 - 14:22:14 |
| Date Modified | 2019/05/29 - 15:15:52 |
| Notes and Attachments | PubMed entry (Attachment) |
Institut de Recherche en Cancérologie de
