Puntambekar Shailesh, Kenawadekar Rahul, Kumar Sanjay, Joshi Saurabh, Agarwal Geetanjali, Reddy Sunil, Mallik Jainul
Galaxy Care Laparoscopy Institute, Opposite Garware College, 25-A, Ayurvedic Rasashala Premises, Karve Road, Pune, Maharashtra, 411004, India.
Department of Surgery, JNMC, KLE University, Belgaum, India.
BMC Surg. 2015 Apr 23;15:47. doi: 10.1186/s12893-015-0024-2.
We have initially published our experience with the robotic transthoracic esophagectomy in 32 patients from a single institute. The present paper is the extension of our experience with robotic system and to best of our knowledge this represents the largest series of robotic transthoracic esophagectomy worldwide. The objective of this study was to investigate the feasibility of the robotic transthoracic esophagectomy for esophageal cancer in a series of patients from a single institute.
A retrospective review of medical records was conducted for 83 esophageal cancer patients who underwent robotic esophagectomy at our institute from December 2009 to December 2012. All patients underwent a thorough clinical examination and pre-operative investigations. All patients underwent robotic esophageal mobilization. En-bloc dissection with lymphadenectomy was performed in all cases with preservation of Azygous vein. Relevant data were gathered from medical records.
The study population comprised of 50 men and 33 women with mean age of 59.18 years. The mean operative time was 204.94 mins (range 180 to 300). The mean blood loss was 86.75 ml (range 50 to 200). The mean number of lymph node yield was 18. 36 (range 13 to 24). None of the patient required conversion. The mean ICU stay and hospital stay was 1 day (range 1 to 3) and 10.37 days (range 10 to 13), respectively. A total of 16 (19.28%) complication were reported in these patents. Commonly reported complication included dysphagia, pleural effusion and anastomotic leak. No treatment related mortality was observed. After a median follow-up period of 10 months, 66 patients (79.52%) survived with disease free stage.
We found robot-assisted thoracoscopic esophagectomy feasible in cases of esophageal cancer. The procedure allowed precise en-bloc dissection with lymphadenectomy in mediastinum with reduced operative time, blood loss and complications.
我们最初发表了在一家机构对32例患者进行机器人辅助经胸食管癌切除术的经验。本文是我们在机器人系统方面经验的扩展，据我们所知，这代表了全球最大规模的机器人辅助经胸食管癌切除术系列。本研究的目的是在一家机构的一系列患者中探讨机器人辅助经胸食管癌切除术治疗食管癌的可行性。
对2009年12月至2012年12月在我院接受机器人食管癌切除术的83例食管癌患者的病历进行回顾性分析。所有患者均接受了全面的临床检查和术前检查。所有患者均接受了机器人食管游离术。所有病例均进行了整块切除并清扫淋巴结，保留奇静脉。从病历中收集相关数据。
研究人群包括50名男性和33名女性，平均年龄59.18岁。平均手术时间为204.94分钟（范围180至300分钟）。平均失血量为86.75毫升（范围50至200毫升）。平均淋巴结清扫数量为18.36枚（范围13至24枚）。无一例患者需要中转手术。平均重症监护病房停留时间和住院时间分别为1天（范围1至3天）和10.37天（范围10至13天）。这些患者中共报告了16例（19.28%）并发症。常见的并发症包括吞咽困难、胸腔积液和吻合口漏。未观察到与治疗相关的死亡。中位随访期为10个月后，66例患者（79.52%）存活且无疾病进展。
我们发现机器人辅助胸腔镜食管癌切除术在食管癌病例中是可行的。该手术能够在纵隔内进行精确的整块切除并清扫淋巴结，同时减少了手术时间、失血量和并发症。
