Abstract
There is no study comparing open esophagectomy (OE), video-assisted thoracic surgery (VATS), and robot-assisted minimally invasive esophagectomy (RAMIE) in a single institution. This study included 272 patients who underwent subtotal esophagectomy divided into three groups: OE (n=110), VATS (n=127), and RAMIE (n=35) groups. Moreover, short-term outcomes were compared. Overall complications (CD≥II) were significantly less in the RAMIE than the OE and VATS groups. Recurrent laryngeal nerve paralysis (CD≥II) was significantly lower in the RAMIE than the OE group (p=0.026) and tended to be lower than that in the VATS group (p=0.059). The RAMIE group had significantly less atelectasis (CD≥I and II), pleural effusion (CD≥I and II), arrhythmia (CD≥II), and dysphagia (CD≥II), than both the OE and VATS groups. RAMIE reduced overall postoperative complications after esophagectomy compared with both OE and VATS.
Highlights
Esophageal cancer is the sixth leading cause of cancerrelated mortality worldwide because of its high malignant potential and poor prognosis [1]
Most studies have reported that the incidence of pulmonary complications was lower in video-assisted thoracoscopic surgery (VATS) than in open esophagectomy (OE)
There were no significant differences between VATS and OE concerning the incidence of anastomotic leakage and Recurrent laryngeal nerve paralysis (RLNP) [20]
Summary
The remaining 272 patients were divided into three groups according to the thoracic approach: OE group (n=110), VATS group (n=127), and RAMIE group (n=35; Figure 1). Most operations in the hospital included three-field LN dissection with an anastomosis in the neck (76.1%) This operation includes a right transthoracic subtotal esophagectomy and dissection of cervical (bilateral supraclavicular region), mediastinal (periesophagus and around the trachea, including the bilateral recurrent laryngeal nerve), and abdominal (perigastric and around the celiac axis) LNs. The other procedures in this study were two-field LN dissection (2FLND) with an anastomosis in the neck (23.9%). The other procedures in this study were two-field LN dissection (2FLND) with an anastomosis in the neck (23.9%) This operation includes a right transthoracic subtotal esophagectomy and dissection of mediastinal and abdominal LNs. All patients underwent LN dissection of the bilateral recurrent laryngeal nerves regardless of the procedures. P
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