Minimally Invasive Esophagectomy in Prone or Left Decubitus Position: A Prospective Randomized Clinical Trial From A Single Institution
Thoracoscopic esophagectomy is routinely performed in two positions. The left decubitus
position is the most commonly used position at most centers. However prone position is
another alternative.
The left decubitus position is advocated for its the same position as the open procedure and
easy to learn, as well as easy to emergent conversion to open thoracotomy .However, the
disadvantage of this position is the need of lung retraction for better exposure and
definitely one lung ventilation. They are regarded as potential causes leading lung injury.
Prone thoracoscopic esophageal mobilization has been advocated for its potential benefits of
increased operative exposure, no lung retraction, avoid one lung ventilation, improved
surgeon ergonomics. But it is difficult to make emergent conversion under this positon and
not familiar with most thoracic or digestive surgeons. A longer learning curve may be
needed.
A few publications have compared the two position with thoracoscopic mobilization of the
esophagus in retrospective study of a small cohort. Until now, no prospective randomized
study has been carried out in this field.
Interventional
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment
Perioperative morbidity and mortality from the two groups
1 —5 years after surgery
Yes
China: Ministry of Health
ZSchest2010001
NCT01144325
July 2010
December 2016
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