Robot-assisted thoracoscopic lymphadenectomy along the left recurrent laryngeal nerve for esophageal squamous cell carcinoma in the prone position: Technical report and short-term outcomes

Koichi Suda, Yoshinori Ishida, Yuichiro Kawamura, Kazuki Inaba, Seiichiro Kanaya, Satoshi Teramukai, Seiji Satoh, Ichiro Uyama

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Background Meticulous mediastinal lymphadenectomy frequently induces recurrent laryngeal nerve palsy (RLNP). Surgical robots with impressive dexterity and precise dissection skills have been developed to help surgeons perform operations. The objective of this study was to determine the impact on short-term outcomes of robot-assisted thoracoscopic radical esophagectomy performed on patients in the prone position for the treatment of esophageal squamous cell carcinoma, including its impact on RLNP. Methods A single-institution nonrandomized prospective study was performed. The patients (n = 36) with resectable esophageal squamous cell carcinoma were divided into two groups: patients who agreed to robot-assisted thoracoscopic esophagectomy with total mediastinal lymphadenectomy performed in the prone position (n = 16, robot-assisted group) without insurance reimbursement, and those who agreed to undergo the same operation without robot assistance but with health insurance coverage (n = 20, control group). These patients were observed for 30 days following surgery to assess short-term surgical outcomes, including the incidence of vocal cord palsy, hoarseness, and aspiration. Results Robot assistance significantly reduced the incidence of vocal cord palsy (p = 0.018) and hoarseness (p = 0.015) and the time on the ventilator (p = 0.025). There was no in-hospital mortality in either group. There were no significant differences between the two groups with respect to patient background, except for the use of preoperative therapy (robot-assisted group <control, p = 0.003). There were no significant differences in estimated blood loss, operating time, number of dissected lymph nodes, completeness of resection, or the incidence of the other complications, except for anastomotic leakage (p = 0.038). Conclusion Robot-assisted thoracoscopic esophagectomy with total mediastinal lymphadenectomy is feasible and safe. This method shows promise in preventing RLNP.

Original languageEnglish
Pages (from-to)1608-1616
Number of pages9
JournalWorld Journal of Surgery
Volume36
Issue number7
DOIs
Publication statusPublished - 2012 Jul
Externally publishedYes

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Recurrent Laryngeal Nerve
Vocal Cord Paralysis
Prone Position
Lymph Node Excision
Esophagectomy
Hoarseness
Incidence
Anastomotic Leak
Insurance Coverage
Mechanical Ventilators
Health Insurance
Hospital Mortality
Insurance
Ambulatory Surgical Procedures
Dissection
Lymph Nodes
Esophageal Squamous Cell Carcinoma
Prospective Studies
Control Groups
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Robot-assisted thoracoscopic lymphadenectomy along the left recurrent laryngeal nerve for esophageal squamous cell carcinoma in the prone position : Technical report and short-term outcomes. / Suda, Koichi; Ishida, Yoshinori; Kawamura, Yuichiro; Inaba, Kazuki; Kanaya, Seiichiro; Teramukai, Satoshi; Satoh, Seiji; Uyama, Ichiro.

In: World Journal of Surgery, Vol. 36, No. 7, 07.2012, p. 1608-1616.

Research output: Contribution to journalArticle

Suda, Koichi ; Ishida, Yoshinori ; Kawamura, Yuichiro ; Inaba, Kazuki ; Kanaya, Seiichiro ; Teramukai, Satoshi ; Satoh, Seiji ; Uyama, Ichiro. / Robot-assisted thoracoscopic lymphadenectomy along the left recurrent laryngeal nerve for esophageal squamous cell carcinoma in the prone position : Technical report and short-term outcomes. In: World Journal of Surgery. 2012 ; Vol. 36, No. 7. pp. 1608-1616.
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