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Robotic transthoracic esophagectomy
Shailesh Puntambekar1, Rahul Kenawadekar2,3, Sanjay Kumar2
1Galaxy Care Laparoscopy Institute, Opposite Garware College, 25-A, Ayurvedic Rasashala Premises, Karve Road, Pune, Maharashtra, 411004, India. shase63@gmail.com.
BMC Surgery
|April 23, 2015
Summary
This study shows robotic transthoracic esophagectomy is a feasible and safe procedure for esophageal cancer, offering reduced operative time, blood loss, and complications in a large patient series.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Initial experience with robotic transthoracic esophagectomy in 32 patients was previously published.
- This study extends the experience, representing the largest series of robotic transthoracic esophagectomy globally.
- Focuses on a single institute's experience.
Purpose of the Study:
- To investigate the feasibility of robotic transthoracic esophagectomy for esophageal cancer.
- To evaluate outcomes in a large series of patients undergoing this procedure.
Main Methods:
- Retrospective review of 83 esophageal cancer patients who underwent robotic esophagectomy (December 2009 - December 2012).
- All patients had clinical examination, pre-operative investigations, and robotic esophageal mobilization.
- En-bloc dissection with lymphadenectomy and Azygous vein preservation were performed.
Main Results:
- The study included 83 patients (50 male, 33 female; mean age 59.18 years).
- Mean operative time was 204.94 minutes, mean blood loss 86.75 ml, with a mean lymph node yield of 18.36.
- 19.28% of patients experienced complications (dysphagia, pleural effusion, anastomotic leak); no treatment-related mortality was observed. Median follow-up was 10 months, with a 79.52% disease-free survival rate.
Conclusions:
- Robot-assisted thoracoscopic esophagectomy is feasible for esophageal cancer.
- The procedure enables precise en-bloc dissection and lymphadenectomy in the mediastinum.
- Associated with reduced operative time, blood loss, and complications.
