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Updated: Aug 5, 2026
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Three-region approach for #106recR lymph node dissection during robot-assisted minimally invasive esophagectomy: a
Tomonori Nakanoko1,2, Kenoki Ohuchida3,4, Sokichi Matsumoto3,4
1Department of Surgery and Science, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka City, 812-8582, Fukuoka, Japan. nakanoko.tomonori.186@m.kyushu-u.ac.jp.
Purpose:
To develop a standardized and reproducible technique for #106recR lymph node dissection during robot-assisted minimally invasive esophagectomy (RAMIE) and to elucidate its feasibility and clinical outcomes in comparison with those of minimally invasive esophagectomy (MIE).
Methods:
We developed a three-region approach for #106recR lymph node dissection, dividing the operative field into lateral, nerve branch, and medial areas based on the right recurrent laryngeal nerve (RtRN). A total of 140 patients who underwent curative esophagectomy were included: 70 underwent MIE and 70 underwent RAMIE. Dissection time for #106recR lymph nodes and postoperative outcomes were evaluated.
Results:
The median dissection time for #106recR lymph nodes was significantly shorter in the RAMIE group than in the MIE group (25 [12-49] vs. 30 [13-35] min, P < 0.01). When divided into early and late phases, the dissection time significantly decreased in the MIE group (P < 0.01), whereas no significant difference was observed in the RAMIE group (P = 0.27). The number of retrieved #106recR lymph nodes and postoperative complications, including recurrent laryngeal nerve palsy, were comparable between the groups.
Conclusions:
This stepwise approach appears feasible in clinical practice and may help promote consistent operative performance, although further validation is needed.
