Robot-assisted thoracoscopic oesophagectomy for cancer

Br J Surg. 2009 Aug;96(8):878-86. doi: 10.1002/bjs.6647.

Abstract

Background: Thoracoscopic oesophagectomy was introduced to reduce the morbidity of transthoracic oesophagectomy. The aim was to assess the short- and mid-term results of robot-assisted thoracoscopic oesophagectomy for oesophageal cancer.

Methods: Between October 2003 and May 2007, 47 patients with resectable oesophageal cancer underwent robot-assisted thoracoscopic oesophagectomy. Clinical data were collected prospectively.

Results: Conversion to thoracotomy was necessary in seven patients. Median operating time was 450 min and median blood loss 625 ml. Median postoperative ventilation time was 1 day, intensive care stay 3 days and hospital stay 18 days. Twenty-one of 47 patients had pulmonary complications. Three patients died in hospital. A median of 29 (range 8-68) lymph nodes was dissected and R0 resection was achieved in 36 patients. Twenty-three patients had stage IVa disease. After a median follow-up of 35 months, median disease-free survival was 15 (95 per cent confidence interval 12 to 18) months.

Conclusion: Robot-assisted thoracoscopic oesophagectomy was oncologically acceptable. Operating time, blood loss and pulmonary complications might decrease with further experience.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Blood Loss, Surgical
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / methods*
  • Female
  • Humans
  • Length of Stay
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Prospective Studies
  • Robotics*
  • Thoracoscopy / methods*
  • Treatment Outcome