Tsuji Toshikatsu, Inaki Noriyuki, Kinoshita Jun, Moriyama Hideki, Yamamoto Daisuke, Saito Hiroto, Doden Kenta
Department of Gastrointestinal Surgery, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan.
Ann Thorac Cardiovasc Surg. 2025;31(1). doi: 10.5761/atcs.cr.25-00065.
The malignancy risk has increased following improvements in the long-term survival rates after liver transplantation. Reports show a 23.4-fold increase in the risk of de novo esophageal cancer after liver transplantation compared to the general population. We report the case of a 47-year-old female diagnosed with early esophageal cancer after liver transplantation. Endoscopic submucosal dissection was performed; however, due to it being a noncurative resection, additional treatment was required. Total robot-assisted minimally invasive esophagectomy (RAMIE) was performed using a robot for thoracic and abdominal procedures. Although extensive adhesions were observed after liver transplantation, precise surgery using the robot did not damage any vital organs, such as the graft blood vessels. The patient was discharged without postoperative complications. Total RAMIE for esophageal cancer after liver transplantation is a feasible and safe option following careful evaluation of the patient's condition, and expands the possibilities of successful complex posttransplant surgeries through robotic precision.
随着肝移植术后长期生存率的提高，恶性肿瘤风险有所增加。报告显示，肝移植后新发食管癌的风险比普通人群高23.4倍。我们报告了一例47岁女性在肝移植后被诊断为早期食管癌的病例。进行了内镜下黏膜下剥离术；然而，由于这是一次非根治性切除，需要额外的治疗。使用机器人进行胸腔和腹部手术，实施了全机器人辅助微创食管切除术（RAMIE）。尽管肝移植后观察到广泛粘连，但使用机器人进行的精确手术并未损伤任何重要器官，如移植血管。患者术后无并发症出院。对患者病情进行仔细评估后，肝移植后食管癌的全RAMIE是一种可行且安全的选择，并通过机器人的精确性扩大了成功进行复杂移植后手术的可能性。
