Huang Lingling, Onaitis Mark
Department of Surgery, Duke University, Durham, NC, USA.
J Thorac Dis. 2014 May;6 Suppl 3(Suppl 3):S314-21. doi: 10.3978/j.issn.2072-1439.2014.04.32.
Esophageal cancer is the eighth most common malignancy and the sixth most common cause of cancer-related death worldwide. Esophagectomy provides a curative treatment but carries significant morbidity and mortality. Ivor Lewis esophagectomy (ILE) is one of the most commonly employed open techniques of esophagectomy. Minimally invasive approaches have been explored in ILE in an effort to reduce operative morbidity. This article reviews recent literature of minimally invasive Ivor Lewis esophagectomy (MI-ILE), discusses its clinical outcomes, and introduces the robotic approach in MI-ILE. MI-ILE has demonstrated comparable postoperative outcomes to open ILE, and it has shown potential to reduce blood loss and length of hospitalization. Due to limited studies, no significant improvement of long-term survival has been reported in MI-ILE. Robotic ILE is safe and feasible, but more studies are needed to prove identifiable benefits. Randomized controlled trials comparing MI-ILE or robotic ILE with conventional open ILE are warranted to determine the optimal surgical procedure for the treatment of esophageal cancer.
食管癌是全球第八大常见恶性肿瘤，也是癌症相关死亡的第六大常见原因。食管切除术是一种根治性治疗方法，但具有较高的发病率和死亡率。艾弗·刘易斯食管切除术（ILE）是最常用的开放性食管切除技术之一。为了降低手术发病率，人们在ILE中探索了微创方法。本文回顾了微创艾弗·刘易斯食管切除术（MI-ILE）的近期文献，讨论了其临床结果，并介绍了MI-ILE中的机器人手术方法。MI-ILE已显示出与开放性ILE相当的术后结果，并且有减少失血和缩短住院时间的潜力。由于研究有限，MI-ILE尚未报告长期生存率有显著提高。机器人ILE是安全可行的，但需要更多研究来证明其明确的益处。有必要进行随机对照试验，比较MI-ILE或机器人ILE与传统开放性ILE，以确定治疗食管癌的最佳手术方法。
