Why Use the Robotic System for the Esophageal Cancer in Minimally Invasive Surgery Era?—Current Status of Robotic Esophagectomy in the World—

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 1338

Special Issue Editors


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Guest Editor
Division of Esophageal Surgery, National Cancer Center Hospital, Tokyo 104-0045, Japan
Interests: surgical oncology for esophageal cancer

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Guest Editor
Division of Thoracic Surgery, Chang Gung Memorial Hospital-Linkou, College of Medicine, Chang Gung University, Taoyüan 333, Taiwan
Interests: surgical oncology for esophageal and lung cancer

Special Issue Information

Dear Colleagues, 

Minimally Invasive Esophagectomy (MIE) in the left lateral and prone position was first reported in the 1990s. The prone position can provide direct viewing of the esophagus without organ compression and provides a stable and wide operative field, the anatomy of the mediastinum has become better understood in esophagectomy. Therefore, the transthoracic approach of MIE in the prone position has been widely accepted and has helped standardize esophagectomy, even in complicated operations. MIE has already become the standard surgical procedure overseas because of its advantages over OPEN thoracotomy; MIE can provide both early recovery after esophagectomy for the patient and an understanding of the anatomy of the surgeon. Moreover, MIE has already begun a paradigm shift toward robotic esophagectomy. This is because the robotic surgical system can facilitate precise surgical techniques by the robotic end-list function and provide magnified microanatomy by the robotic 3D high solution endoscopy. Robotic esophagectomy is still in the implementation phase overseas, and several robotic advantages over OPEN and thoracoscopic esophagectomy have been reported. Cancers will feature robotic-assisted MIE in the double 20 era and inform the current status of robotic esophagectomy in each country, but why use a robotic system for esophageal cancer in the era of minimally invasive surgery?

Dr. Hiroyuki Daiko
Prof. Dr. Yin-Kai Chao
Guest Editors

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Keywords

  • esophageal cancer
  • esophagectomy
  • robotic surgery
  • robotic esophagectomy
  • Minimally Invasive Esophagectomy

Published Papers (1 paper)

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Research

13 pages, 904 KiB  
Article
Incidence and Predictors of Textbook Outcome after Minimally Invasive Esophagectomy for Cancer: A Two-Center Study
by Evangelos Tagkalos, Peter Grimminger, Xing Gao, Chien-Hung Chiu, Eren Uzun, Hauke Lang, Yu-Wen Wen and Yin-Kai Chao
Cancers 2024, 16(6), 1109; https://doi.org/10.3390/cancers16061109 - 09 Mar 2024
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Abstract
Purpose: The textbook outcome (TBO), a multidimensional indicator that reflects an optimal perioperative course, has emerged as a significant prognostic variable in surgical oncology. Our study aimed to assess the occurrence and determinants of TBO following minimally invasive esophagectomy (MIE) for cancer. Methods: [...] Read more.
Purpose: The textbook outcome (TBO), a multidimensional indicator that reflects an optimal perioperative course, has emerged as a significant prognostic variable in surgical oncology. Our study aimed to assess the occurrence and determinants of TBO following minimally invasive esophagectomy (MIE) for cancer. Methods: A total of 945 patients who had undergone MIE at two high-volume centers between 2008 and 2022 were analyzed. Multivariable logistic regression analysis was applied to identify the independent predictors of TBO. The potential selection bias associated with choosing between different MIE techniques—namely, robotic esophagectomy (RE) and video-assisted thoracoscopic esophagectomy (VATE)—was addressed by applying inverse probability of treatment weighting (IPTW). Results: TBO was realized in 46.6% of cases (n = 440), correlating with markedly better overall and disease-free survival. Multivariable analysis showed that treatment with RE (odds ratio (OR) = 1.527; 95% confidence interval (CI) = 1.149–2.028) was associated with a higher likelihood of achieving TBO, whereas a Charlson Comorbidity Index (CCI) of 2 or higher showed an opposite association (CCI2: OR = 0.687, 95% CI = 0.483–0.977; CCI ≥ 3: OR = 0.604, 95% CI = 0.399–0.915). The advantage of RE in attaining a higher rate of TBO, compared to VATE, remained statistically significant after applying IPTW, with rates of 53.3% for RE and 42.2% for VATE. Notably, RE contributed to a greater probability of thorough lymph node dissection, resection with negative margins, and the avoidance of major complications. Conclusion: TBO was realized in 46.6% of the patients who underwent MIE for cancer. Patients with a lower CCI and those who received RE were more likely to achieve TBO. Full article
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