Incidence Of Recurrent Laryngeal Palsy Research Articles

Abstract Background Minimally invasive esophagectomy (MIE) has become increasingly adopted as a standard surgical approach for esophageal cancer because of less tissue damage and a more rapid recovery. Recent developments in robotic technology have made robot-assisted minimally esophagectomy as another surgical option for MIE. The aim of the study was to compare early results between robot-assisted thoraco-laparoscopic esophagectomy (RATLE) and conventional thoraco-laparoscopic esophagectomy(CTLE) for the treatment of esophageal squamous cell carcinoma (ESCC). Methods We designed a randomized controlled parallel-group trial study. Patients aged 18–75 years with histologically proven surgically resectable (cT1b-3, N0–2, M0) ESCC of the intrathoracic esophagus were randomly assigned to receive either RATLE or CTLE. All patients received McKeown esophagectomy. Clinical characteristics and perioperative outcomes between the two groups were compared. Results Seventy patients were randomly assigned to RATLE group(n = 36) and CTLE group(n = 34). The two groups were comparable in preoperative clinical characteristics. Patients who underwent RATLE had shorter total operation time than the CTLE group (217.3 ± ± 44.5 vs. 261.5 ± 62.1 minutes, P = 0.001), particularly in thoracoscopic time (74.0 ± 23.6 vs. 104.1 ± 34.2 minutes, P < 0.001). The incidence of recurrent laryngeal palsy is higher in RATLE group(25%) than CTLE group(11.8%), but it was not statistically significant (P = 0.155). Intraoperative blood loss, length of hospital stay and the incidence of postoperative complications were not statistically different between the two groups. Four (11.1%) patients have anastomotic leakage in the RATLE group, compared to 4 (11.8%) patients in the CTLE group (P = 0.772). The RATLE and CTLE groups did not differ significantly with regard to the total number of harvested lymph nodes (18.8 ± 7.0 vs. 20.1 ± 8.3, P = 0.468), the numbers of lymph nodes dissected from recurrent laryngeal nerve chains(4.7 ± 3.1 vs. 4.9 ± 3.4, P = 0.779) and the abdomen(5.9 ± 3.5 vs. 5.1 ± 3.1, P = 0.354). Conclusion There is technical superiority with shorter operation time and similar short-term surgical results for RATLE compared with CTLE. Though the incidence of postoperative recurrent laryngeal palsy is slightly higher for RATLE, it doesn’t affect postoperative recovery. Long-term survival data should be followed in the future to compare the oncological outcome between the two groups. Disclosure All authors have declared no conflicts of interest.

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