PS01.217: COMPARISON OF THE SHORT-TERM OUTCOMES OF LATERAL POSITIONING AND PRONE POSITIONING DURING THORACOSCOPIC ESOPHAGECTOMY.

Background Video-assisted thoracoscopic esophagectomy (VATS-E) for esophageal cancer is being performed at an increasing number of institutions. In our institute, at first, we had performed VATS-E in the left lateral position without pneumothorax. But, we introduced VATS-E in the prone position with pneumothorax, because of difficulty of visual development for a surgical site by assistant. This study aimed to compare the two methods and to clarify the advantage in the prone position. Methods Thirty-one patients who underwent VATS-E at the Department of Gastroenterological Surgery, Kagawa University, from August 2013 to January 2018 were divided into two groups by the patient position. For the first 17 patients, we used the left lateral position (Group L); for the next 14 patients, we used the prone position (Group P). We compared the short-term outcomes in these two approaches. Results There were no significant differences in the most operative factors; duration of the thoracoscopic esophagectomy (354 min. in Group L and 309 min. in Group P, P  = 0.153), operative hemorrhage (421 ml in Group L and 228ml in Group P, P  = 0.054), infusion volume (8.8 ml/kg/hr. in Group L and 8.2ml/kg/hr. in Group P, P  = 0.415), urinary volume (2.3 ml/kg/hr. in Group L and 1.7ml/kg/hr. in Group P, P  = 0.202). However, C-reactive protein (CRP) level in post-operative day 3 (17.2 in Group L and 13.8 in Group P, P  = 0.046) and procalcitonin (PCT) level in post-operative day 3 (1.8 in Group L and 0.3 in Group P, P  = 0.049) was significantly lesser in Group P. And, Period until ambulation (4.0 days in Group L and 1.3 days in Group P, P  < 0.001) was significantly shorter in Group P. Conclusion In conclusion, VATS-E in the prone position is lesser invasive and faster recovery than in the left lateral position. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]