完全机器人辅助食管癌切除术治疗恶性肿瘤的早期经验。手术及肿瘤学结果。
Early experience with totally robotic esophagectomy for malignancy. Surgical and oncological outcomes.
作者信息
Guerra Francesco, Vegni Alessandra, Gia Elena, Amore Bonapasta Stefano, Di Marino Michele, Annecchiarico Mario, Coratti Andrea
机构信息
Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy.
出版信息
Int J Med Robot. 2018 Jun;14(3):e1902. doi: 10.1002/rcs.1902. Epub 2018 Mar 6.
BACKGROUND
Over recent decades, minimally invasive esophagectomy has gained popularity and is increasingly performed worldwide. The aim of this work was to investigate the perioperative, clinicopathologic, and oncological outcomes of robot-assisted esophagectomy on a consecutive series of totally robotic procedures.
METHODS
All patients received either an Ivor Lewis or a McKeown procedure according to tumor location. Perioperative, clinicopathologic and oncological outcomes were examined.
RESULTS
A total of 38 patients underwent robot-assisted esophagectomy procedures. All underwent surgery for primary esophageal neoplasms. Neoadjuvant therapy was given to 22 patients. R0 resections were achieved in all patients and no conversion to open surgery occurred. Overall morbidity and mortality were 42% and 10%, respectively. The 1 year disease free survival was 78.9%, whereas the 1 year overall survival was 84.2%.
CONCLUSIONS
Robotic surgery can be employed to treat esophageal malignancy competently. Robotic esophagectomy satisfies all features of pathologic appropriateness and offers the expected oncological results.
背景
近几十年来，微创食管切除术越来越受欢迎，在全球范围内的开展也日益增多。本研究旨在探讨连续一系列全机器人手术的机器人辅助食管切除术的围手术期、临床病理及肿瘤学结果。
方法
所有患者根据肿瘤位置接受艾弗·刘易斯手术或麦克基翁手术。对围手术期、临床病理及肿瘤学结果进行检查。
结果
共有38例患者接受了机器人辅助食管切除术。所有患者均接受了原发性食管肿瘤手术。22例患者接受了新辅助治疗。所有患者均实现了R0切除，且未转为开放手术。总体发病率和死亡率分别为42%和10%。1年无病生存率为78.9%，而1年总生存率为84.2%。
结论
机器人手术可有效用于治疗食管恶性肿瘤。机器人辅助食管切除术满足病理适宜性的所有特征，并提供了预期的肿瘤学结果。
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