474. ESOPHAGEAL CANCER SURGERY AND ITS CHALLENGES: A STEP AHEAD WITH THE INTRODUCTION OF ROBOT-ASSISTED SURGERY. (24th September 2022)

• Record Type: Journal Article
• Authors: Noma, Kazuhiro; Hashimoto, Masashi; Maeda, Naoaki; Tanabe, Shunsuke; Shirakawa, Yasuhiro; Fujiwara, Toshiyoshi
• Is Part Of: Diseases of the esophagus. Volume 35(2022)Supplement 2
• Publication Date: 2022-09-24
• Subjects: Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1093/dote/doac051.474
• Languages: English
• ISSNs: 1120-8694

Abstract

Abstract: We introduced robot-assisted thoracoscopic surgery for esophageal cancer surgery in 2018 and have performed 143 cases so far. Compared with thoracoscopic surgery, robot-assisted surgery is overwhelmingly more stable and precise, however there are concerns about the safety because there is no sensation from the forceps. Here, we will show a video of a standardized procedure utilizing the characteristics of da Vinci and its application to advanced cancer, and discuss the safe use of da Vinci. We compared the short-term outcomes of pretreatment cStage ≤ II (n=40) and cStage ≥ III (n=53) in a total of 93 single-operator cases out of 143 da Vinci esophageal operations performed at our department since 2018. For all patients, thoracoscopic time: mean 227 minutes, blood loss: 185 ml, recurrent nerve palsy: 15 patients (16.1%), postoperative hospital stay: 29.4 days, R0 surgery achievement rate: 96.8%. By stage (cStage ≤ II vs. ≥ III), thoracoscopic time: 211 vs. 240 minutes (p<0.05), blood loss: 171 vs. 195 ml (p=0.5), paralysis: 22.5 vs. 11.3% (p=0.17), postoperative hospital stay: 27.4 vs. 30.8 days (p=0.2). Although thoracoscopic time was significantly longer in the advanced cancer group, there was no difference in blood loss or hospital stay between the two groups, and paralysis was less common. We focused on the effectiveness of robot-assisted thoracoscopic esophageal surgery for advanced cancer. Although robot-assisted surgery tends to take a relatively long time, we believe that it can be performed safely and effectively even for advanced cancer by careful surgical manipulation.