Robotic-assisted minimally invasive esophagectomy for treatment of esophageal carcinoma

被引：21

作者：

Chiu P.W. ^{[1
,2
,3
]}

Teoh A.Y. ^{[1
,3
]}

Wong V.W. ^{[1
,3
]}

Yip H.C. ^{[1
,3
]}

Chan S.M. ^{[1
,3
]}

Wong S.K. ^{[1
,3
]}

Ng E.K. ^{[1
,2
,3
]}

机构：

[1] CUHK Jockey Club Minimally Invasive Surgical Skills Center, The Chinese University of Hong Kong

[2] Chow Yuk Ho Technology Center for Innovative Medicine, The Chinese University of Hong Kong

[3] Division of Upper GI and Metabolic Surgery, Department of Surgery, The Chinese University of Hong Kong

来源：

Journal of Robotic Surgery | 2017年 / 11卷 / 2期

关键词：

Carcinoma of esophagus; Minimally invasive esophagectomy; Robotic esophagectomy; Robotic surgery;

D O I：

10.1007/s11701-016-0644-2

中图分类号：

学科分类号：

摘要：

Minimally invasive esophagectomy (MIE) is technically challenging. Da Vinci Robotic system could improve surgical dissection with additional degree of freedom from robotic arms. This study aimed to assess the feasibility and safety of performing MIE using Da Vinci Robotic system among patients with esophageal cancers. From 2009 to 2013, consecutive patients with esophageal cancers who received robotic-assisted MIE were recruited. We excluded tumors with suspected invasion to adjacent organs. Preoperative staging included EUS, CT thorax and abdomen and bronchoscopy. We perform mobilization of thoracic esophagus with two-field lymphadenectomy using robotic system, followed by laparoscopic gastric mobilization and hand-sewn cervical esophagogastric anastomosis. A total of 20 patients were recruited (16 male and 4 female) with mean age of 64.2 ± 8.8 years. All patients were successfully treated with robotic-assisted MIE with mean operative time of 499.5 ± 70 min and blood loss of 355.7 ± 329.6 mls. There was no pulmonary complication, while three patients sustained anastomotic leakage and managed conservatively. The mean hospital stay was 13 ± 6 days. Five patients had stage I tumors, five had stage II, and nine had stage III disease. One patient had complete response after neoadjuvant chemoradiotherapy. The number of lymph node dissection was 18.2 ± 13.2, and 2.8 ± 5.7 nodes involved. The follow-up period was 21 ± 9 months, and the overall survival was 75 %. Robotic-assisted MIE is feasible and safe for treatment of esophageal cancers. The surgical dissection can be enhanced by improved ergonomics from robotic arms and sense of depth from 3D images. © 2016, Springer-Verlag London.

引用

页码：193 / 199

页数：6

共 18 条

[1]

Brusselaers N., Mattsson F., Lagergren J., Hospital and surgeon volume in relation to long-term survival after oesophagectomy: systematic review and meta-analysis, Gut, 63, 9, pp. 1393-1400, (2014)

[2]

Tachibana M., Kinugasa S., Yoshimura H., Shibakita M., Tonomoto Y., Dhar D.K., Nagasue N., Clinical outcomes of extended esophagectomy with three field lymph node dissection for esophageal squamous cell carcinoma, Am J Surg, 189, pp. 98-109, (2005)

[3]

Hagen J.A., DeMeester S.R., Peters J.H., Chandrasoma P., DeMeester T.R., Curative resection for esophageal adenocarcinoma: analysis of 100 En Bloc Esophagectomies, Ann Surg, 234, 4, pp. 520-531, (2001)

[4]

Hulscher J.B., van Sandick J.W., De Boer A.G., Wijnhoven B.P., Tijssen J.G., Fockens P., Stalmeier P.F., Ten Kate F.J., van Dekken H., Obertop H., Tilanus H.W., van Lanschot J.J., Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus, N Engl J Med, 347, 21, pp. 1662-1669, (2002)

[5]

Hulscher J.B., Tijssen J.G., Obertop H., van Lanschot J.J., Transthoracic versus transhiatal resection for carcinoma of the esophagus: a meta-analysis, Ann Thorac Surg, 72, pp. 306-313, (2001)

[6]

Luketich J.D., Pennathur A., Awais O., Levy R.M., Keeley S., Shende M., Christie N.A., Weksler B., Landreneau R.J., Abbas G., Schuchert M.J., Nason K.S., Outcomes after minimally invasive esophagectomy: review over 1000 patients, Ann Surg, 256, pp. 95-103, (2012)

[7]

Law S., Wong J., Two field dissection is enough for esophageal cancer, Dis Esophagus, 14, pp. 98-103, (2001)

[8]

Omloo J.M., Lagarde S.M., Hulscher J.B., Reitsma J.B., Forkens P., van Dekken H., ten Kate F.J., Obertop H., Tilanus H.W., van Lanschot J.J., Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the mid/distal esophagus, Ann Surg, 246, pp. 992-1001, (2007)

[9]

Cuschieri A., Shimi S., Banting S., Endoscopic oesophagectomy through a right thoracoscopic approach, J R College Surg Edinb, 37, pp. 7-11, (1992)

[10]

Smithers B.M., Gotley D.C., Martin I., Thomas J.M., Comparison of the outcomes between open and minimally invasive esophagectomy, Ann Surg, 245, 2, pp. 232-240, (2007)

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