Abstract
ObjectiveTo observe the surgical index at the different learning stages of thoraco-laparoscopic esophagectomy in the prone position for esophageal cancer and to investigate the learning curve of this surgical procedure.MethodsSixty thoraco-laparoscopic esophagectomies in the prone position for esophageal cancer conducted by the same group of surgeons between January 2014 and December 2015 were retrospectively analyzed. The surgeries were divided into 5 groups, A, B, C, D, and E, in chronological order. The duration of surgery, intraoperative blood loss, total number of lymph nodes removed, rate of the intraoperative conversion to open surgery, complication rate, and length of postoperative hospitalization were recorded and analyzed.ResultsThe general information of the patients did not significantly differ among the 5 groups (P > 0.05). The duration of surgery, intraoperative blood loss, number of lymph node removed, rate of intraoperative conversion to open surgery, and number of injuries to the recurrent laryngeal nerve all significantly differed (P < 0.05). The rates of postoperative pulmonary infection, anastomotic fistula, pneumothorax, and hospitalization did not significantly differ (P > 0.05).ConclusionThoracic physicians with some endoscopic experience can meet the requirements of the thoraco-laparoscopic esophagectomy in the prone position for esophageal cancer after completing 24–30 surgeries.
Highlights
Esophagectomy is the main treatment for esophageal cancer [1, 2], but traditional open surgery is associated with significant trauma and various complications that affect the efficacy of treatment
The present study retrospectively analyzes 60 thoraco-laparoscopic esophagectomies in the prone position for esophageal cancer conducted by the same team of surgeons and analyzes the surgical indices during different stages to investigate the learning curve associated with this surgical procedure
Blunt and sharp dissections of the esophagus were alternated, and care was taken to protect the recurrent laryngeal nerve while moving downwards to the top of right chest; the esophagus was pulled out through the esophageal bed and left neck incision, and dissection was continued the middle of the thyroid; an incision was made in the cervical esophagus, and a disposable needle was inserted pointing to the seat of a curved anastomosis stapler; ligation was performed with a purse-string suture; the prepared tubular stomach was pulled out to the neck through the esophageal bed and left neck incision, and a disposable curved anastomosis stapler was used to perform a mechanical anastomosis of the tubular stomach-left neck end of esophagus
Summary
Esophagectomy is the main treatment for esophageal cancer [1, 2], but traditional open surgery is associated with significant trauma and various complications that affect the efficacy of treatment. Wang et al Journal of Cardiothoracic Surgery (2020) 15:116 the surgeon to master both thoracoscopy and laparoscopy techniques; the surgery is more difficult, and its risk is relatively high. To completely master this surgical procedure and accumulate enough experience, surgeons undergo must go a learning curve of exploration, consolidation, improvement, and perfection [8]. The present study retrospectively analyzes 60 thoraco-laparoscopic esophagectomies in the prone position for esophageal cancer conducted by the same team of surgeons and analyzes the surgical indices during different stages to investigate the learning curve associated with this surgical procedure
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
