Author of

• 12495

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  P3.07 - Poster Session 3 - Surgery (ID 193)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12523

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    P3.07-028 - Long-term result of robot-assisted esophagectomy for esophageal cancer: Technical feasibility and oncological reliability. (ID 2229)

    09:30 - 09:30  |  Author(s): Y.H. Whang
    • Abstract

    Background
    Whether robot-assisted esophagectomy is a technically feasible and oncologically reliable operation for esophageal cancer has not been proven. This study aimed to evaluate short-term and long-term outcomes of robot-assisted esophagectomy.

    Methods
    Robot-assisted esophagectomy was performed in prone position for cervical anastomosis or lateral position for intrathoracic anastomosis. Thoracic procedures were performed by totally robotic technique and abdominal procedures were performed by robot or laparotomy. Two field lymph node dissection was performed in all patients and dissection along both recurrent laryngeal nerves was performed in the patients with T1b or more stages. Retrospective review on short-term and long-term outcomes for robot-assisted esophagectomy was performed.

    Results
    Robot-assisted esophagectomy was performed in 46 patients between 2008 and 2013, which was 16% of total esophagectomy cases during the same period. There were 43 men and 3 women and mean age was 63.9 ± 8.2 years. Preoperative clinical stages were IA in 19 patients (41%), IB in 8 (17%), IIA in 6 (13%), IIB in 9 (20%), and IIIA in 4 (9%). Neoadjuvant chemoradiation was performed in 5 patients (11%). Abdominal procedures were performed by robot in 29 patients (63%) and by laparotomy in 16 (35%). R0 resection was accomplished in 45 patients (98%) and mean operation time including robot docking time were 512 ± 104 minutes. Total 2-field lymph node dissection along bilateral recurrent laryngeal nerve was performed in 32 patients (70%) and mean number of dissected lymph nodes were 29.1 ± 14.1. Cell types of esophageal cancer were squamous cell carcinoma in 45 patients (98%) and melanoma in 1 patient (2%). Pathologic stages were IA in 9 patients (20%), IB in 19 (41%), IIA in 2 (4%), IIB in 11 (24%), IIIA in 4 (9%), and IIIB in 1 (2%). There were one 30-day mortality (2%) and postoperative complication occurred in 15 patients (33%); respiratory complication in 5 patients (11%), anastomosis site leakage in 5 (11%), and vocal cord palsy requiring treatment in 3 (7%). Overall 5-year survival was 88% and 5-year freedom from recurrence was 73%. Locations of recurrence were regional in 4 patients (9%), distant in 4 (9%), and there was no local recurrence.

    Conclusion
    Robot-assisted esophagectomy was technically feasible and oncologically reliable surgery in this study. Further studies based on large series of data are necessary to prove advantages of robot-assisted esophagectomy.