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Published in:

01-07-2012

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

Published in: World Journal of Surgery | Issue 7/2012

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.

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Title: 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
Publication date: 01-07-2012
Published in: World Journal of Surgery / Issue 7/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-012-1538-8

At a glance: The ONWARDS insulin icodec trials

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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

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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