Abstract
Nowadays many patients with esophageal cancer are treated with thoracoscopic esophagectomy (TE) with precise mediastinal lymphadenectomy as a minimally invasive esophagectomy (MIE) in Japan. These advanced endoscopic surgeries are believed to contribute to early postoperative recovery. More recently robotic esophagectomy (RE) appeared attractively. To date, however, there has been a very limited number of comparison studies to verify the benefits of RE for esophageal cancer, especially in Japan where squamous cell carcinoma is predominant.
Methods
We retrospectively compared the short-term outcomes between TE (n = 43) and RE (n = 19) which were performed in our institution between 2018 and 2020 to verify the clinical significance of RE. Preoperative background factors of the patients compared were almost identical between the two groups.
Results
The operative time was longer in the RE group than in the OE group, whereas blood loss was equivalent between the two groups. There was no significant differences in the number of dissected mediastinal lymph nodes between the TE and RE groups (33+/−15 vs 29+/−11).
The incidence of postoperative recurrent laryngeal nerve palsy was markedly less in the RE group than the TE group (5.2% vs. 18.6%). Moreover, the incidence of postoperative pneumonia also tended to be less in the RE group than in the TE group (5.2% vs. 11.6%). There were no operative mortality in the two groups.
Conclusion
Our results suggest that RE is comparable with conventional TE in terms of short-term outcome after surgery, and beneficial to technically reduce the recurrent laryngeal nerve palsy as a promising MIE.
A Strategy for Using Intraoperative Nerve Monitoring During Esophagectomy to Prevent Recurrent Laryngeal Nerve Palsy
