ヨシダ　カズヒロ   Kazuhiro Yoshida   吉田　和弘    所属   川崎医科大学  医学部 臨床医学　総合外科学    職種   准教授
言語種別	英語
発表タイトル	THE USEFULNESS OF THE LEFT LATERAL DECUBITUS POSITION IN THE THORACOSCOPIC ESOPHAGECTOMY
会議名	21st International Congress of the European Association for Endoscopic Surgery
学会区分	国際学会及び海外の学会
発表者・共同発表者	◎Shigemitsu Kaori,　Hirabayashi　Yoko,　Takaoka Munenori,　Fukazawa Takuya,　Hayashi Jiro,　Urakami Atsushi,　Yoshida Kazuhiro,　Yamatsuji Tomoki,　Nakashima Kazutaka,　Morita Ichiro,　Naomoto Yoshio
発表年月日	2013/06/19
開催地 （都市, 国名）	Vienna, Austria
概要	In recent years, with the spread of thoracoscopic esophagectomy has also diversified its procedures. There is a prone position and the left lateral decubitus position as a representative, with the presence or absence of pneumothorax. Advantages of the prone position are that it does not require a mastery of the assistant, and a good viewing in dissection of the middle and lower mediastinal lymph nodes. The advantages of the left lateral decubitus position are that the good viewing in dissection of the upper mediastinal lymph nodes as well as open-thorasic surgery is obtained and that it is easy to support unexpected conditions, such as bleeding, and the like. At our institution, in introducing thoracoscopic esophagectomy in May 2012, the first to ensure the safety, we adopt the left lateral decubitus position with pneumothorax which does not require a mastery of assistant. Using 2 monitors reversing, both surgeon and assistant can obtain the eye-hand coodination simultaneously As carbon dioxide is introduced into the intrathorasic space, we can obtain good surgical view. We show the point of the procedure of thracoscopic esophagectomy with lymphadenectomy, such as dissection of recurrent nerve lymph nodes, in the left lateral decubitus position with pneumothorax. We performed thoracoscopic esophagectomy for 7 patients with esophageal cancer from May 2012 to January 2013 with no major postoperative or intraoperative complications. Postoperative hospital stay was shorter in the patients treated with thoracoscopic esophagectomy in comparison with those treated with open esophagectomy.