Outcomes of robotic esophagectomy

Journal of Thoracic Disease

article

Amy Young¹  José María Alvarez Gallesio²  David B. Sewell³  Rebecca Carr³  Daniela Molena³ 

[1] Department of Surgery, Philadelphia College of Osteopathic Medicine;Department of Surgery, Division of Cardiothoracic Surgery, Hospital Alemán of Buenos Aires;Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center

关键词: Esophageal cancer;    esophagectomy;    open thoracotomy;    minimally invasive esophagectomy (MIE);    robotic-assisted esophagectomy;   

DOI  :  10.21037/jtd-2019-rts-07

学科分类：呼吸医学

来源: Pioneer Bioscience Publishing Company

【 摘 要 】

Esophagectomy has long been considered the standard of care for early-stage (≤ T2N0) esophageal cancer. Minimally invasive esophagectomy (MIE), using a combined laparoscopic and thoracoscopic approach, was first performed in the 1990s and showed significant improvements over open approaches. Refinement of MIE arrived in the form of robotic-assisted minimally invasive esophagectomy (RAMIE) in 2004. MIE is a challenging procedure for which consensus on optimal technique is still elusive. Although nonrobotic MIE confers significant advantages over open approaches, MIE remains associated with stubbornly high rates of complications, including pneumonia, aspiration, arrhythmia, anastomotic leakage, surgical site infection, and vocal cord palsy. RAMIE was envisioned to improve operative-associated morbidity while achieving equivalent or superior oncologic outcomes to nonrobotic MIE. However, owing to RAMIE’s significant upfront costs, steep learning curve, and other requirements, adoption remains less than widespread and convincing evidence supporting its use from well-designed studies is lacking. In this review, we compare operative, oncologic, and quality-of-life outcomes between open esophagectomy, nonrobotic MIE, and RAMIE. Although RAMIE remains a relatively new and underexplored modality, several studies in the literature show that it is feasible and results in similar outcomes to other MIE approaches. Moreover, RAMIE has been associated with favorable patient satisfaction and quality of life.

【 授权许可】

Unknown