scholarly journals Influence of Neoadjuvant Chemotherapy on Short-term Outcomes After Minimally Invasive Esophagectomy for Esophageal Cancer

2018 ◽  
Vol 39 (1) ◽  
pp. 471-475
Author(s):  
DAICHI NOMOTO ◽  
NAOYA YOSHIDA ◽  
TAKAHIKO AKIYAMA ◽  
YUKI KIYOZUMI ◽  
KOJIRO ETO ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Short Term ◽  
Invasive Esophagectomy

Early outcomes of minimally invasive esophagectomy after neoadjuvant chemotherapy for esophageal squamous cell carcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Võ Vĩnh Lộc Nguyễn ◽  
Keyword(s):  
Esophageal Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Minimally Invasive ◽  
Lymph Nodes ◽  
Minimally Invasive Esophagectomy ◽  
Locally Advanced ◽  
Postoperative Mortality ◽  
Thoracic Esophagus ◽  
Invasive Esophagectomy ◽  
Stage Ib

Abstract Introduction: Neoadjuvant chemotherapy (NAC) is the standard treatment which recommended for resectable locally advanced esophageal cancer (EC), but the safety of minimally invasive esophagectomy (MIE) after neoadjuvant chemotherapy (NAC) for esophageal cancer has not been reported. We investigated the effect of NAC on the safety and feasibility of MIE for EC.The purpose of this study was to evaluate the morbidity, mortality and oncologic outcomes of MIE after neoadjuvant chemotherapy. Materials and Methods: This was a prospective study of the patients who underwent MIE after neoadjuvant chemotherapy between August 2018 and May 2020. Patients with clinical stage IB, IIA, IIB, IIIA, IIIB, or IIIC EC, and no active concomitant malignancy were included. The data regarding the intraoperative incident, postoperative morbidity and mortality as well as oncologic examination were collected and analyzed. Results: From August 2018 to May 2020, 68 patients with EC have been included into the study. There were 66 males and 2 females with mean age of 58.1 ± 13.9 (42 – 77). Sixty-two patients had neoadjuvant with DCX, four patients were indicated for EOX therapy, and remained two patients were treated by PAR-CAR. Two patients with stage IB, 23 with stage IIA, 22 with stage IIB, 14 with stage IIIA, one with stage IIIB, and 6 with stage IIIC. Tumor located in middle thoracic esophagus was 34 (50%), lower thoracic esophagus was 32 (47.1%) and upper thoracic esophagus was 2 cases. Median operation time was 420 minutes with minimal blood loss. Median hospitalization duration was 11 days (7 – 31). Median lymph nodes harvested in cervical, mediastinal and abdominal fields was 10, 16 and 7 respectively. Twenty-seven (42.2%) patients had metastatic lymph nodes. Postoperative mortality was 1.5% (1 case). Overall morbidity was 33.8% included 6 cases complicated pneumonia, 9 cases with anastomotic leak (conservative treatment), 1 case was re-operated due to cervical lymph leak, 16 cases with temporary hoarse voice. Conclusion: Results from our study to conclude that MIE is safe and effective for locally advanced EC, even after NAC. Key word: Neoadjuvant chemotherapy, minimally invasive esophagectomy, esophageal cancer. Tóm tắt Đặt vấn đề: Hóa trị tân hỗ trợ là điều trị tiêu chuẩn cho ung thư thực quản tiến triển tại chỗ, nhưng đến tính an toàn và khả thi của phẫu thuật nội soi cắt thực quản sau hóa trị tân hỗ trợ vẫn chưa được báo cáo. Chúng tôi đánh giá ảnh hưởng của hóa trị tân hỗ trợ lên tính an toàn và khả thi của phẫu thuật nội soi cắt thực quản sau hóa trị tân hỗ trợ. Nghiên cứu đánh giá tỉ lệ tai biến, biến chứng, tử vong và kết quả ung thư học của phẫu thuật nội soi cắt thực quản sau hóa trị tân hỗ trợ. Phương pháp nghiên cứu: Nghiên cứu tiến cứu, đánh giá các người bệnh phẫu thuật nội soi cắt thực quản sau hóa trị tân hỗ trợ từ tháng 8 năm 2018 đến tháng 5 năm 2020. Chúng tôi chọn những người bệnh ung thư thực quản giai đoạn IB, IIA, IIB, IIIA, IIIB và IIIC và không có ung thư khác kèm theo. Tai biến, biến chứng, tử vong và kết quả ung thư học sẽ được đánh giá. Kết quả: Từ tháng 8 năm 2018 đến tháng 5 năm 2020, có 68 người bệnh đạt tiêu chuẩn nghiên cứu. Có 66 nam và 2 nữ, tuổi trung bình là 58,1 ± 13,9 (42 – 77). 62 người bệnh hóa trị với phác đồ DCX, 4 người bệnh hóa trị với phác đồ EOX và 2 người bệnh hóa trị với phác đồ PAR-CAR. Có 2 người bệnh giai đoạn IB, 23 người bệnh giai đoạn IIA, 22 người bệnh giai đoạn IIB, 14 người bệnh giai đoạn IIIA, 1 người bệnh giai đoạn IIIB và 6 người bệnh giai đoạn IIIC. U nằm ở thực quản ngực giữa ở 34 (50%) người bệnh, thực quản ngực dưới ở 32 (47,1%) người bệnh và thực quản ngực trên ở 2 người bệnh. Thời gian mổ trung vị là 420 phút, máu mất không đáng kể. Thời gian nằm viện trung vị là 11 ngày (7 – 31). Số hạch nạo được trung vị ở cổ là 10, trung thất là 16 và bụng là 7. Có 27 (42.2%) người bệnh có di căn hạch. Tử vong chu phẫu là 1,5% (1 người bệnh). Tỉ lệ biến chứng là 33,8% gồm 6 viêm phổi, 9 rò miệng nối (điều trị bảo tồn), 1 ca rò bạch huyết cần mổ lại và 16 ca khàn tiếng tạm thời. Kết luận: Từ những kết quả đạt được, phẫu thuật nội soi cắt thực quản sau hóa trị tân hỗ trợ là phẫu thuật an toàn và khả thi. Từ khóa: Hóa trị tân hỗ trợ, phẫu thuật nội soi cắt thực quản, ung thư thực quản.

P123 ROBOT ASSISTED MINIMALLY INVASIVE ESOPHAGECTOMY (RAMIE4) WITH INTRATHORACIC ANASTOMOSIS: PROMISING RESULTS AND LESSONS LEARNED IN 100 PATIENTS

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
E Tagkalos ◽  
der Sluis P C van ◽  
E Hadzijusufovic ◽  
B Babic ◽  
E Uzun ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Case Series ◽  
Oncologic Outcomes ◽  
Robot Assisted ◽  
Short Term ◽  
Intrathoracic Anastomosis ◽  
Invasive Esophagectomy

Abstract Aim The aim of this study was to describe postoperative complications and short-term oncologic outcomes for RAMIE4 with intrathoracic anastomosis for esophageal cancer within our case series of 100 consecutive patients. Background & Methods Robot assisted minimally-invasive esophagectomy (RAMIE) with intrathoracic anastomosis is gaining popularity as a treatment for esophageal cancer. In this study, we present the results of 100 RAMIE procedures using the da Vinci Xi robotic system (RAMIE4). The aim of this study was to describe postoperative complications and short-term oncologic outcomes for RAMIE4 within our case series of 100 consecutive patients. Between January 2017 and February 2019, data of 100 consecutive patients with esophageal carcinoma undergoing modified Ivor-Lewis esophagectomy were prospectively collected. All operations were performed by the same surgeon using an identical intrathoracic anastomotic reconstruction technique with the same perioperative management and pain control regimen. Intra-operatively and post operatively complications were graded according to definitions stated by the Esophagectomy Complications Consensus Group (ECCG). Results Mean duration of the surgical procedure was 416 min (± 80). In total, 70 patients (70%) had an uncomplicated operative procedure and postoperative recovery. Pulmonary complications were most common and were observed in 17 patients (17 %). Anastomotic leakage was observed in 8 patients (8%). Median ICU stay was 1 day and median overall postoperative hospital stay was 11 days. 30 day mortality was 1%. A R0 resection was reached in 92% of patients with a median number of 29 dissected lymph nodes. Conclusion RAMIE4 with intrathoracic anastomosis for esophageal cancer or cancer located in the esophagus was technically feasible and safe. Postoperative complications and short term oncologic results were comparable to the highest international standards nowadays. These results could only be obtained due to a structured RAMIE training pathway. The superiority of RAMIE compared to conventional minimally invasive esophagus is currently investigated in multiple randomized controlled trials. Results of these trials will define the role for RAMIE for patients with esophageal cancer in the future.

PS01.220: COMPARISON OF SHORT-TERM OUTCOMES BETWEEN RAMIE AND VAMIE IN TREATMENT MIDDLE THORACIC ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 112-112
Author(s):  
Yidan Lin ◽  
Hanyu Deng
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Lymph Nodes ◽  
Conflicts Of Interest ◽  
Minimally Invasive Esophagectomy ◽  
Operation Time ◽  
Short Term ◽  
Thoracic Esophageal Cancer ◽  
Comparable Rate ◽  
Invasive Esophagectomy

Abstract Background Whether robot-assisted minimally invasive esophagectomy (RAMIE) has any advantages over video-assisted minimally invasive esophagectomy (VAMIE) remains controversial. In this study, we tried to compare the short-term outcomes of RAMIE with that of VAMIE in treating middle thoracic esophageal cancer from a single medical center. Methods Consecutive patients undergoing RAMIE or VAMIE for middle thoracic esophageal cancer from April 2016 to April 2017 were prospectively included for analysis. Baseline data and pathological findings as well as short-term outcomes of these two group (RAMIE group and VAMIE group) patients were collected and compared. A total of 84 patients (RAMIE group: 42 patients, VAMIE group: 42 patients) were included for analysis. Results The baseline characteristics between the two groups were comparable. RAMIE yielded significantly larger numbers of total dissected lymph nodes (21.9 and 17.8, respectively; P = 0.042) and right recurrent laryngeal nerve (RLN) lymph nodes (2.1 and 1.2, respectively; P = 0.033) as well as abdominal lymph nodes (10.8 and 7.7, respectively; P = 0.041) than VAMIE. Even though RAMIE may consume more overall operation time, it could significant decrease total blood loss compared to VAMIE (97 and 161 ml, respectively; P = 0.015). Postoperatively, no difference of the risk of major complications or hospital stay was observed between the two groups. Conclusion RAMIE had significant advantage of lymphadenectomy especially for dissecting RLN lymph nodes over VAMIE with comparable rate of postoperative complications. Further randomized controlled trials are badly needed to confirm and update our conclusions. Disclosure All authors have declared no conflicts of interest.

scholarly journals Comparison of Up-Front Minimally Invasive Esophagectomy versus Open Esophagectomy on Quality of Life for Esophageal Squamous Cell Cancer

2021 ◽  
Vol 28 (1) ◽  
pp. 693-701
Author(s):  
Zhenhua Li ◽  
Jingge Cheng ◽  
Yuefeng Zhang ◽  
Shiwang Wen ◽  
Huilai LV ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Short Term ◽  
European Organization ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy ◽  
Better Than

This study investigates whether minimally invasive esophagectomy (MIE) is a safe and effective way for patients with resectable esophageal cancer by comparing the short-term quality of life (QOL) after minimally invasive esophagectomy and open esophagectomy (OE). A total number of 104 patients who underwent esophagectomy from January 2013 to March 2014 were enrolled in this study. These patients were divided into two groups (MIE and OE group). Three scoring scales of quality of life were used to evaluate QOL before the operation and at the first, third, sixth and twelfth months after MIE or OE, which consist of Karnofshy performance scale (KPS), the European Organization for Research and Treatment questionnaire QLQC-30 (EORTC QLQC-30) and esophageal cancer supplement scale (OES-18). The MIE group was higher than the OE group in one-year survival rate (92.54% vs. 72.00%). Significant differences between the two groups were observed in intraoperative bleeding volume (158.53 ± 91.07 mL vs. 228.97 ± 109.33 mL, p = 0.001), and the incidence of postoperative pneumonia (33.33% vs. 58.62%, p = 0.018). The KPS of MIE group was significantly higher than the OE group at the first (80 vs. 70, p = 0.004 < 0.05), third (90 vs. 80, p = 0.006 < 0.05), sixth (90 vs. 80, p = 0.007 < 0.05) and twelfth months (90 vs. 80, p = 0.004 < 0.05) after surgery. The QLQC-30 score of MIE group was better than OE group at first and twelfth months after the operation. The OES-18 score of MIE group was significantly better than OE group at first, sixth and twelfth months after surgery. The short-term quality of life in MIE group was better than OE group.

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