Robot‐Assisted Thoracoscopic Hybrid Esophagectomy in the Semi‐Prone Position Under Pneumothorax

Ishikawa, Norihiko; Kawaguchi, Masahiko; Inaki, Noriyuki; Moriyama, Hideki; Shimada, Masanari; Watanabe, Go

doi:10.1111/aor.12018

Cited by 15 publications

(8 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The application of robotic technology is mainly focused on lymph node dissection along RLN because this is regarded a key step in curative resection for squamous cell carcinoma. As expected, Asian series reported a larger number of mediastinal lymph nodes with a higher rate of RLN palsy . Considering that interest in RATE is increasing in this region where VATS‐E with extensive ML is popular, more studies on RATE with extensive ML will undoubtedly be performed in the near future.…”

Section: Discussionmentioning

confidence: 99%

“…29 In comparison with Western series, RATE in the prone or semi-prone position followed by cervical esophagogastrostomy is preferred in Asian series. The application of robotic technology is mainly focused on lymph node dissection along RLN 8,10,31 because this is regarded a key step in curative resection for squamous cell carcinoma. As expected, Asian series reported a larger number of mediastinal lymph nodes with a higher rate of RLN palsy.…”

Section: Discussionmentioning

confidence: 99%

“…As expected, Asian series reported a larger number of mediastinal lymph nodes with a higher rate of RLN palsy. 8,10,31 Considering that interest in RATE is increasing in this region where VATS-E with extensive ML is popular, more studies on RATE with extensive ML will undoubtedly be performed in the near future.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Robot-assisted thoracoscopic esophagectomy with extensive mediastinal lymphadenectomy: experience with 114 consecutive patients with intrathoracic esophageal cancer

Park

Kim

et al. 2015

Dis Esophagus

View full text Add to dashboard Cite

The study aims to report the operative outcomes of robot-assisted thoracoscopic esophagectomy (RATE) with extensive mediastinal lymphadenectomy (ML) for intrathoracic esophageal cancer. We analyzed a prospective database of 114 consecutive patients who underwent RATE with lymph node dissection along recurrent laryngeal nerve (RLN) followed by cervical esophagogastrostomy. The study included 104 men with a mean age of 63.1 ± 0.8 years. Of these, 110 (96.5%) had squamous cell carcinoma, and the location of the tumor was upper esophagus in 7 (6.1%), middle in 62 (54.4%), and lower in 45 (39.5%). Preoperative concurrent chemoradiation was performed in 15 patients (13.2%). All but one patient underwent successful RATE, and R0 resection was achieved in 111 patients (97.4%). Extended ML and total ML were performed in 24 (21.1%) and 90 (78.9%) patients, respectively. Total operation time was 419.6 ± 7.9 minutes, and robot console time was 206.6 ± 5.2 minutes. The mean number of total, mediastinal, and RLN nodes was 43.5 ± 1.4, 24.5 ± 1.0, and 9.7 ± 0.7, respectively. The most common complication was RLN palsy (30, 26.3%), followed by anastomotic leakage (17, 14.9%) and pulmonary complications (11, 9.6%). Median hospital stay was 16 days, and 90-day mortality was observed in three patients (2.5%). On multivariate analysis, preoperative concurrent chemoradiation was a risk factor for pulmonary complications (odds ratio 7.42, 95% confidence interval 1.91-28.8, P = 0.004). RATE with extensive ML could be performed safely with acceptable postoperative outcomes. Long-term survival data should be followed in the future to verify the oncological outcome of the procedure.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Robot-assisted thoracoscopic esophagectomy with extensive mediastinal lymphadenectomy: experience with 114 consecutive patients with intrathoracic esophageal cancer

Park

Kim

et al. 2015

Dis Esophagus

View full text Add to dashboard Cite

show abstract

“…The results of publications that included robot‐assisted oesophagectomy are shown in Table . As for gastrectomy, early reports are case reports or small case series but more recent reports have larger numbers and results comparable to conventional surgery.…”

Section: Resultsmentioning

confidence: 99%

Robot‐assisted gastrectomy and oesophagectomy for cancer

Falkenback

Lehane

Lord

2014

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background: Robot-assisted surgery is a technically feasible alternative to open and laparoscopic surgery, which is being more frequently used in general surgery. We undertook this review to investigate whether robotic assistance provides a significant benefit for oesophagogastric cancer surgery. Methods: Electronic databases were searched for original English-language publications for robotic-assisted gastrectomy and oesophagectomy between January 1990 and October 2013. Results: Sixty-one publications were included. Thirty-five included gastrectomy, 31 included oesophagectomy and five included both operations. Several publications suggest that robot-assisted subtotal gastrectomy can be as safe and effective as an open or laparoscopic procedure, with equal outcomes with regard to the number of lymph nodes resected, overall morbidity and perioperative mortality, and length of hospital stay. Robotic assistance is associated with longer operation times but also with less blood loss in some reports. A significant benefit for robotic assistance has not been shown for the more extensive operations of oesophagectomy or total gastrectomy with D2-lymphadenectomy. There are very few oncologic data regarding local recurrence or long-term survival for any of the robotic operations. Conclusions: No significant differences in morbidity, mortality or number of lymph node harvested have been shown between robot-assisted and laparoscopic gastrectomy or oesophagectomy. Robotic surgery, with its relatively short learning curve, may facilitate reproducible minimally invasive surgery in this field but operation times are reportedly longer and cost differences remain unclear. Randomized trials with oncologic outcomes and cost comparisons are needed.

show abstract

“…60) There are four articles related to three-stage RAE performed in the prone or semi-prone position (Table 4). 35,[60][61][62] In all four reports, no patients required conversion to either thoracoscopy or thoracotomy, and the rates of respiratory complications were quite low. In a study of the largest number of patients, Puntambekar, et al 61) reported a single institution experience of 32 RAE procedures in which mobilization of the esophagus was performed with the patient in the prone position.…”

Section: Robotically-assisted Esophageal Surgery In the Prone Positionmentioning

confidence: 89%

Thoracoscopic Esophagectomy Using Prone Positioning

Noshirο

Miyake

2013

ATCS

View full text Add to dashboard Cite

Thoracotomic esophagectomy followed by cervical and abdominal procedures has been conventionally performed as the best curable operative procedure for treating invasive thoracic esophageal carcinoma. Despite improvements in the survival rate, the procedure is associated with significant operative morbidity and mortality rates due to the extreme invasiveness of an extensive dissection of the lymph nodes. Minimally invasive esophagectomy (MIE) was developed to reduce surgical invasiveness. Recently, the use of thoracoscopic esophagectomy performed in the prone position has stimulated new interest in minimally invasive approaches. However, the advantages and disadvantages of this technique are not well known. In this review, the literature to date, including series and comparative studies of minimally invasive esophagectomy performed in the prone position, is summarized, and the various lessons learned and controversies surrounding this technique are addressed.

show abstract

Robot‐Assisted Thoracoscopic Hybrid Esophagectomy in the Semi‐Prone Position Under Pneumothorax

Cited by 15 publications

References 15 publications

Robot-assisted thoracoscopic esophagectomy with extensive mediastinal lymphadenectomy: experience with 114 consecutive patients with intrathoracic esophageal cancer

Robot-assisted thoracoscopic esophagectomy with extensive mediastinal lymphadenectomy: experience with 114 consecutive patients with intrathoracic esophageal cancer

Robot‐assisted gastrectomy and oesophagectomy for cancer

Thoracoscopic Esophagectomy Using Prone Positioning

Contact Info

Product

Resources

About