Anesthetic Management of Video-assisted Thoracoscopic Esophagectomy - Comparison of Prone Position and Left Lateral Position

We retrospectively reviewed outcomes of video-assisted thoracoscopic surgery of the esophagus (VATS-E) in the left lateral position (group L, n=70) and in the prone position (group P, n=70) in our hospital. The maximum arterial carbon dioxide tension was higher and a marked reduction in percutaneous arterial oxygen saturation was more common in group P. Moreover, the induction time of anesthesia was longer in group P, in which it was more difficult to change postural position. However, the amount of bleeding, total infusion volume, intraoperative water balance, the incidence of arrhythmia, and poor surgical field visibility during thoracic manipulation were significantly lower in group P than in group L. Thus, VATS-E in the prone position provided stable hemodynamics and safe management of patients, although there remain issues to be resolved, including respiratory care and changes in postural position.