Clinical utility of robot-assisted transthoracic esophagectomy in advanced esophageal cancer after neoadjuvant chemoradiation therapy.

Abstract:

Background:Although robot-assisted minimally-invasive esophagectomy (RAMIE) surgeries are expanding clinically, few studies have reported patients with locally-advanced esophageal cancer who underwent neoadjuvant chemoradiation therapy (nCRT). Methods:From 2013 to 2017, 219 patients with esophageal squamous cell carcinoma underwent RAMIE and 35 of them received nCRT at our institution. During the period, 289 patients underwent conventional open esophagectomy (OE) and 111 patients underwent nCRT. We compared postoperative mortality and morbidity of RAMIE and OE patients after nCRT. Results:In patients who received nCRT, the RAMIE and OE groups had similar operative time, estimated blood loss, early-period mortality, and recurrence rate (≤1 year) and both groups showed a high rate of complete resection. With respect to postoperative morbidities, such as anastomotic leakage, chylothorax, postoperative bleeding, and wound infection, only vasopressor use was significantly higher in the OE group (P<0.001). The RAMIE group had a lower, but not statistically significant, postoperative pneumonia incidence than the OE group (5.7% vs. 13.5%, P=0.341). Conclusions:In patients who received nCRT for locally-advanced esophageal cancer, RAMIE is safe and feasible with comparable postoperative mortality and morbidity to conventional OE. Patients with advanced-stage esophageal cancer who received nCRT may be surgical candidates for RAMIE.

journal_name

J Thorac Dis

authors

Yun JK,Lee IS,Gong CS,Kim BS,Kim HR,Kim DK,Park SI,Kim YH

doi

10.21037/jtd.2019.07.53

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

2913-2923

issue

7

eissn

2072-1439

issn

2077-6624

pii

jtd-11-07-2913

journal_volume

11

pub_type

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