Robotic surgery for the upper gastrointestinal tract: Current status and future perspectives

Nakauchi, Masaya; Uyama, Ichiro; Suda, Koichi; Mahran, Mohamed; Nakamura, Tetsuya; Shibasaki, Susumu; Kikuchi, Kenji; Kadoya, Shinichi; Inaba, Kazuki

doi:10.1111/ases.12437

Cited by 20 publications

(20 citation statements)

References 67 publications

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“…In Japan, however, Nakauchi et al reported on the initiation in 2009 of robotic gastrectomy and esophagectomy for patients with upper gastrointestinal cancer, and they showed potential advantages of the da Vinci Surgical System in reducing postoperative local complications after gastrectomy and recurrent laryngeal nerve palsy after esophagectomy. However, robotic surgery has the disadvantages of a longer operative time and higher costs than the conventional approach …”

Section: Treatmentsmentioning

confidence: 99%

Recent advancements in esophageal cancer treatment in Japan

Tanaka

Yoshida

Suetsugu

et al. 2018

Annals of Gastroent Surgery

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The 11th edition of the Japanese Classification of Esophageal Cancer (EC) was published in 2017. Some correction was made in the depth of tumor invasion to be consistent with the TNM classification by the Union for International Cancer Control (UICC). With regard to surgery, short‐term safety and long‐term effectiveness under thoracotomy/video‐assisted thoracoscopic surgery are expected to be proven by the Japan Clinical Oncology Group (JCOG)1409 study. Results of nutritional management and countermeasures for adverse events not only during the perioperative period but also during EC chemotherapy were reported. From now on, the pursuit of low invasiveness and radicality is desired. Esophageal surgery is also expected to be safe at all institutions. To determine the optimal modality of preoperative treatment and a novel chemo(radio)therapy regimen for patients with distant metastasis, the results of the ongoing JCOG1109 and 0807 studies are being released. The effect of the addition of molecular targeted drugs on chemotherapy and concurrent chemoradiation has not yet improved overall survival. Immune checkpoint inhibitor drugs could offer a potential new treatment approach for patients with treatment‐refractory advanced squamous cell carcinoma (SCC). The Cancer Genome Atlas Research Network reported the results of a comprehensive genome analysis and molecular analysis of SCC and adenocarcinoma of the esophagus. Further differentiation of SCC and adenocarcinoma by molecular characterization analysis may be useful for the development of clinical trials and targeted drug therapies as precision medicine. The era of ultimate minimally invasive surgery and personalized treatment has begun. Large, prospective studies will be required to confirm the value of these advancements.

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Section: Treatmentsmentioning

confidence: 99%

Recent advancements in esophageal cancer treatment in Japan

Tanaka

Yoshida

Suetsugu

et al. 2018

Annals of Gastroent Surgery

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“…Although several groups have reported the feasibility and safety of a wide range of esophagectomy approaches with good short-term outcomes, these reports were all based on retrospective studies with a small number of patients (16). In 2015, Ruurda et al conducted a systematic review of 16 case series, each consisting of 11-118 cases (73); there were 300 cases in total.…”

Section: Short-term Outcomes Of Robot-assisted Esophagectomymentioning

confidence: 99%

“…In a Western series, LLDP was commonly used and some authors tried thoracic anastomosis. In contrast, in an Asian series, the prone or semiprone positions and cervical anastomosis were preferred .…”

Section: Introductionmentioning

confidence: 98%

“…In clinical practice, cervical anastomosis and intrathoracic anastomosis with the Ivor Lewis procedure have been applied for esophagogastric anastomosis after VATS esophagectomy . In recent years, robot‐assisted thoracoscopic and/or laparoscopic esophagectomy using the da Vinci Surgical System (DVSS) (Intuitive Surgical, Sunnyvale, CA, USA) emerged as an attractive option . Even more recently, non‐thoracic radical esophagectomy via the transcervical and transhiatal approaches with mediastinoscopic devices has been associated with feasible surgical outcomes .…”

Section: Introductionmentioning

confidence: 99%

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Recent advances in thoracoscopic esophagectomy for esophageal cancer

Booka

Takeuchi

Kikuchi

et al. 2018

Asian J Endoscop Surgery

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Technical advances and developments in endoscopic equipment and thoracoscopic surgery have increased the popularity of minimally invasive esophagectomy (MIE). However, there is currently no established scientific evidence supporting the use of MIE as an alternative to open esophagectomy (OE). To date, a number of single‐institution studies and several meta‐analyses have demonstrated acceptable short‐term outcomes of thoracoscopic esophagectomy for esophageal cancer, and we recently reported one of the largest propensity score‐matched comparison studies between MIE and OE for esophageal cancer, based on a nationwide Japanese database. We found that, in general, MIE had a longer operative time and less blood loss than OE. Moreover, compared to OE, MIE was associated with a lower rate of pulmonary complications such as pneumonia, and both methods had similar mortality rates. Although MIE may reduce the occurrence of postoperative respiratory complications, MIE and OE seem to have comparable short‐term outcomes. However, the oncological benefit to patients undergoing MIE remains to be scientifically proven, as no randomized controlled trials have been conducted to verify each method's impact on the long‐term survival of cancer patients. An ongoing randomized phase III study (JCOG1409) is expected to determine the impact of each method with regard to short‐ and long‐term outcomes.

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“…These trials will address some of the future perspective of surgical management of gastric GISTs such as the role of robotic surgery and endoscopic resection. Robotic surgery has been increasing performed in the last decade but the current evidence showed that robotic gastric resections have the disadvantages of longer operating time and higher costs than conventional laparoscopic approach (40).…”

Section: Gastric Gists Trial Studiesmentioning

confidence: 99%

Surgical treatment of gastrointestinal stromal tumors of the stomach: current status and future perspective

Lim

2017

Transl. Gastroenterol. Hepatol.

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Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, with the majority found in the stomach. Surgical resection of the primary gastric GISTs with complete resection margin has been the forefront of curative treatment. The indications for surgical resection are usually related to symptomatic gastric GISTs at presentation. Primary gastric GISTs resection performed conventionally through an open surgery can now be frequently achieved by minimal invasive surgery with similar oncological outcome. Surgeon's selection of the type of surgical techniques such as open, laparoscopic and endoscopic resections depends on the site, size and local invasion of gastric GISTs to the adjacent organ. Similarly those factors dictate the extent of gastric resections in the form of wedge, partial or total gastrectomy. All these inherent tumor factors (size and mitotic index), patient factors (older age, male) and surgical factors (incomplete resection margin, tumor rupture or spillage) play an important role in stratifying the malignant potential risk of primary gastric GISTs and their chances of recurrence. The understanding of gene mutation driving the growth of GISTs and the discovery of tyrosine kinase inhibitors (TKIs) has altered the surgical management of advanced and metastatic GISTs. Multi-modal therapy incorporating the surgical resection of GISTs and utilizing the molecular targeted therapy in the adjuvant, neoadjuvant and palliative settings can offer optimal personalized outcome and prolong patient's overall survival (OS).

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Robotic surgery for the upper gastrointestinal tract: Current status and future perspectives

Cited by 20 publications

References 67 publications

Recent advancements in esophageal cancer treatment in Japan

Recent advancements in esophageal cancer treatment in Japan

Recent advances in thoracoscopic esophagectomy for esophageal cancer

Surgical treatment of gastrointestinal stromal tumors of the stomach: current status and future perspective

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