Three-dimensional visualization system is one of the factors that improve short-term outcomes after minimally invasive e
- PDF / 403,174 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 97 Downloads / 127 Views
ORIGINAL ARTICLE
Three-dimensional visualization system is one of the factors that improve short-term outcomes after minimally invasive esophagectomy Takuya Kudo 1 & Taro Oshikiri 1 & Gosuke Takiguchi 1 & Naoki Urakawa 1 & Hiroshi Hasegawa 1 & Masashi Yamamoto 1 & Shingo Kanaji 1 & Yoshiko Matsuda 1 & Kimihiro Yamashita 1 & Takeru Matsuda 2 & Tetsu Nakamura 1 & Satoshi Suzuki 3 & Yoshihiro Kakeji 1 Received: 7 July 2020 / Accepted: 5 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Minimally invasive esophagectomy (MIE) has been increasingly used, but many reports have stated that recurrent laryngeal nerve (RLN) palsy after MIE is a major complication associated with postoperative pneumonia. Prevention of RLN palsy clearly has been a challenging task. The study aim was to determine if a three-dimensional (3-D) stereoscopic vision system can reduce the RLN palsy rate after MIE. Methods This was a retrospective study of MIE (McKeown esophagectomy) using a 3-D or 2-D stereoscopic vision system to treat 358 patients in the prone position between April 2010 and March 2019. The patients who underwent 3-D MIE (3-D group) or 2-D MIE (2-D group) were matched by using propensity score matching. After matching, the perioperative outcomes were compared between the groups. Results After propensity score matching, 154 patients were analyzed (77 patients, 3-D group; 77 patients, 2-D group). There were no significant differences in the patients’ baseline characteristics in the matched cohort. There were no significant differences in the rates of pneumonia (Clavien–Dindo (C–D) grade ≥ II, 3-D vs. 2-D, 11 (14%) vs. 12 (16%)), anastomotic leakage (C–D grade ≥ II, 10 (13%) vs. 18 (23%)) and mortality. The rates of left RLN palsy (C–D grade ≥ IIIa, 1 (1.3%) vs. 7 (9.1%), P = 0.029), right RLN palsy (C–D grade ≥ I, 2 (3%) vs. 8 (10%), P = 0.049), comprehensive complication index (CCI®) (8.5 vs. 14.3, P = 0.011), and postoperative hospital stay period (median: 25 vs. 30 days, P = 0.034) were significantly lower in the 3-D group than in the 2D group, respectively. Conclusions In MIE, the 3-D viewing system was one of the factors that reduced postoperative morbidities such as the rates of each RLN palsy and CCI®, leading to shorter postoperative hospital stay. Keywords Minimally invasive esophagectomy . 3-dimensional system . Recurrent laryngeal nerve palsy . Postoperative pneumonia
Introduction * Taro Oshikiri [email protected] 1
Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
2
Division of Minimally Invasive Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
3
Division of Community Medicine and Medical Network, Department of Social Community Medicine and Health Science, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
Esophageal cancer
Data Loading...
