Usefulness of prone-position computed tomography as preoperative simulation prior to thoracoscopic esophagectomy for thoracic esophageal cancer
| Autor: | Kentaro Yatabe, Kohei Tajima, Soji Ozawa, Kazuo Koyanagi, Tadashi Higuchi, Tetsu Niwa, Miho Yamamoto, Yamato Ninomiya, Takakiyo Nomura |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Supine position Multivariate analysis Esophageal Neoplasms medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Surgical oncology medicine Prone Position Humans Esophagus Risk factor Retrospective Studies business.industry Gastroenterology Esophagectomy Prone position medicine.anatomical_structure Cardiothoracic surgery 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Radiology business Tomography X-Ray Computed |
| Zdroj: | Esophagus : official journal of the Japan Esophageal Society. 18(4) |
| ISSN: | 1612-9067 |
| Popis: | The study aimed to evaluate the usefulness of prone-position computed tomography (CT) for predicting relevant thoracic procedure outcomes in minimally invasive esophagectomy (MIE) for thoracic esophageal cancer. A total of 59 patients underwent esophagectomy between May 2019 and December 2020 in Tokai University Hospital. Preoperative CT imaging was conducted with the patient in both the supine and prone positions, and the magnitude of change in the intramediastinal space was calculated. In the 56 patients (94.9%) who had undergone MIE, the effects of such a difference on the surgical outcomes were analyzed. A significant correlation of the magnitude of change in VE (distance between ventral aspect of the vertebral body and the midpoint of the esophagus) with the surgical outcome was revealed in the 17 patients (30.4%) in whom the magnitude of change in VE was over the 75th percentile. That is, in this subgroup, the magnitude of change in VE showed a negative correlation with the thoracic operation time (rs = − 0.57, p = 0.01) and blood loss during the thoracic procedure (rs = − 0.46, p = 0.01). Multivariate analysis identified a magnitude of change in VE ≥ 9 mm (OR = 0.14, p = 0.03) as an independent risk factor for postoperative pneumonia. This study indicates that preoperative prone-position CT imaging is useful for predicting the level of ease or difficulty of securing an adequate operative field, surgical outcomes, and the risk of postoperative pneumonia in MIE. |
| Databáze: | OpenAIRE |
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