Comparison of robot-assisted esophagectomy and thoracoscopic esophagectomy in esophageal squamous cell carcinoma

Park, Samina; Hwang, Yoohwa; Lee, Hyun Joo; Park, In Kyu; Kim, Young Tae; Kang, Chang Hyun

doi:10.21037/jtd.2016.10.39

Cited by 80 publications

(129 citation statements)

References 25 publications

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“…Kim et al [58 ]published data on dissection techniques of the upper mediastinum, and Park et al [59] reported excellent 5-year disease-free (76.2%) and overall (79.4%) survival in a cohort of 115 patients undergoing total mediastinal lymphadenectomy. In comparison to the lymph node count reported in large MIE series [17,31], all RAMIE series applying lymph node dissection of the upper mediastinum [57,58,59] reported markedly higher numbers of retrieved lymph nodes (median n = 19-21 (MIE group) vs. n = 37-49 (RAMIE group)).…”

Section: Comparison Of Robotic and Minimally Invasive Esophagectomymentioning

confidence: 78%

“…While no differences in postoperative mortality and disease-free survival between MIE and RAMIE were noted [41], histopathological data from a study by Park et al [57] demonstrated that RAMIE allows for a higher number of lymph nodes retrieved compared to MIE. Kim et al [58 ]published data on dissection techniques of the upper mediastinum, and Park et al [59] reported excellent 5-year disease-free (76.2%) and overall (79.4%) survival in a cohort of 115 patients undergoing total mediastinal lymphadenectomy.…”

Section: Comparison Of Robotic and Minimally Invasive Esophagectomymentioning

confidence: 99%

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Upper Gastrointestinal Surgery: Robotic Surgery versus Laparoscopic Procedures for Esophageal Malignancy

Biebl¹,

Ανδρέου²,

Chopra³

et al. 2018

Visc Med

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Background: The evolution of minimally invasive surgery (MIS) also extends to the field of esophageal surgery and has brought forth the development of several approaches of minimally invasive esophagectomy (MIE). Hybrid and total minimally invasive operative techniques have proven beneficial compared to open surgery and are currently evaluated against robotic-assisted minimally invasive esophagectomy (RAMIE). We aim to review the current literature regarding the position of MIE versus RAMIE. Methods: A systematic review of the relevant literature on minimally invasive esophageal surgery for cancer is presented. A PubMed search was carried out for the period of 1992-2018 with the following search terms: ‘esophageal cancer', ‘minimally invasive surgery', ‘resection', ‘transhiatal', ‘transthoracic', ‘MIE', ‘hybrid', ‘robotic resection', ‘RAMIE', ‘RATE'. Results: Hybrid and total minimally invasive operative techniques have proven beneficial, especially with regard to pulmonary complications, compared to open surgery. Oncologic outcomes appear equivalent between open and minimally invasive techniques. Currently, the position of RAMIE is being evaluated against other minimally invasive techniques. Conclusion: All minimally invasive techniques confer the expected reduction in perioperative morbidity compared to open surgery. However, MIS is still evolving with regard to specific technical challenges, especially anastomotic techniques.

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Section: Comparison Of Robotic and Minimally Invasive Esophagectomymentioning

confidence: 78%

Section: Comparison Of Robotic and Minimally Invasive Esophagectomymentioning

confidence: 99%

Upper Gastrointestinal Surgery: Robotic Surgery versus Laparoscopic Procedures for Esophageal Malignancy

Biebl¹,

Ανδρέου²,

Chopra³

et al. 2018

Visc Med

View full text Add to dashboard Cite

show abstract

“…Five-year overall survival after RAMIE has been reported at 42% and median disease-free survival is 21 months [23]; better quality, complete resection, and lymphadenectomy may provide additional survival outcomes, although survival benefits require further investigation [10].…”

Section: Discussionmentioning

confidence: 99%

“…The safety and feasibility of RAMIE have been demonstrated in recent reports. Short-term oncologic results post-RAMIE have shown that complete resection could be achieved in 77-100% of cases, with harvest of 18-43 lymph nodes [9,10]. Although published reports of experiences with intrathoracic esophagogastrostomy using RAMIE remain limited, the techniques used for intrathoracic esophagogastric anastomosis with robot-assisted Ivor-Lewis esophagectomy (RAILE) are similar to those used in thoracoscopy.…”

Section: Introductionmentioning

confidence: 99%

Modified Intrathoracic Esophagogastrostomy with Minimally Invasive Robot-Assisted Ivor-Lewis Esophagectomy for Cancer

et al. 2018

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Background: Intrathoracic esophagogastrostomy plays an important role in minimally invasive Ivor-Lewis esophagectomy for cancer. Intrathoracic anastomosis with robot-assisted Ivor-Lewis esophagectomy (RAILE) includes hand-sewn and circular stapler methods, which remain technically challenging. In this study, we modified the techniques for intrathoracic anastomosis at RAILE, in order to simplify the complex procedures. Methods: “Side-insertion” technique was used for anvil placement and purse string suture for intrathoracic anastomosis at RAILE. Medical records for consecutive patients who had undergone robot-assisted minimally invasive Ivor-Lewis esophagectomy for cancer between January 2015 and June 2018 were analyzed. Results: A total of consecutive 31 patients were enrolled. There was no conversion to open thoracotomy in this cohort. Mean operation duration in the robotic group was 387.4 ± 68.2 min. Median estimated blood loss was 110 mL (range 50–400 mL). Two patients (6.5%) had postoperative anastomotic leak. No postoperative reoperation was needed and there were no mortality. Six patients (19.4%) had anastomotic stricture and 2 patients of them needed endoscopic dilation. Conclusion: RAILE is safe and feasible. Our modified procedure highlighting the “side-insertion” method may simplify the process of intrathoracic anvil placement and purse string suture for anastomosis at RAILE.

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“…Suda et al25 reported that robotic assistance significantly reduced the incidence of recurrent laryngeal nerve palsy and hoarseness. Park et al44 reported that the total number of dissected lymph nodes was significantly greater in the robotic than in the thoracoscopic groups, especially in the upper mediastinum and abdomen.…”

Section: Comparison With Conventional Proceduresmentioning

confidence: 98%

Robotic surgery for esophageal cancer: Merits and demerits

Seto

Mori

Aikou

2017

Annals of Gastroent Surgery

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Since the introduction of robotic systems in esophageal surgery in 2000, the number of robotic esophagectomies has been gradually increasing worldwide, although robot‐assisted surgery is not yet regarded as standard treatment for esophageal cancer, because of its high cost and the paucity of high‐level evidence. In 2016, more than 1800 cases were operated with robot assistance. Early results with small series demonstrated feasibility and safety in both robotic transhiatal (THE) and transthoracic esophagectomies (TTE). Some studies report that the learning curve is approximately 20 cases. Following the initial series, operative results of robotic TTE have shown a tendency to improve, and oncological long‐term results are reported to be effective and acceptable: R0 resection approaches 95%, and locoregional recurrence is rare. Several recent studies have demonstrated advantages of robotic esophagectomy in lymphadenectomy compared with the thoracoscopic approach. Such technical innovations as three‐dimensional view, articulated instruments with seven degrees of movement, tremor filter etc. have the potential to outperform any conventional procedures. With the aim of preventing postoperative pulmonary complications without diminishing lymphadenectomy performance, a nontransthoracic radical esophagectomy procedure combining a video‐assisted cervical approach for the upper mediastinum and a robot‐assisted transhiatal approach for the middle and lower mediastinum, transmediastinal esophagectomy, was developed; its short‐term outcomes are promising.Thus, the merits or demerits of robotic surgery in this field remain quite difficult to assess. However, in the near future, the merits will definitely outweigh the demerits because the esophagus is an ideal organ for a robotic approach.

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Comparison of robot-assisted esophagectomy and thoracoscopic esophagectomy in esophageal squamous cell carcinoma

Cited by 80 publications

References 25 publications

Upper Gastrointestinal Surgery: Robotic Surgery versus Laparoscopic Procedures for Esophageal Malignancy

Upper Gastrointestinal Surgery: Robotic Surgery versus Laparoscopic Procedures for Esophageal Malignancy

Modified Intrathoracic Esophagogastrostomy with Minimally Invasive Robot-Assisted Ivor-Lewis Esophagectomy for Cancer

Robotic surgery for esophageal cancer: Merits and demerits

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