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Robotic Esophagectomy

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Abstract

Esophagectomy is a complex procedure used in the treatment of malignant and some end-stage benign esophageal conditions. With a long history in clinical applications of over 100 years, multiple modifications of the procedure developed, including establishment of the 3 most common approaches, Ivor Lewis esophagectomy, McKeown esophagectomy, and transhiatal esophagectomy. Since the introduction of minimally invasive techniques at the end of the last century, different modifications of initially thoracoscopic and laparoscopic and later on robotic approaches enjoyed rapid adoption in this field, all in the attempt to minimize morbidity and mortality of the esophagectomy. In this chapter, the authors describe the techniques of robotic esophagectomy and review the current literature on the subject, including postoperative management and management of the complications of the procedure.

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References

  1. Torek F. The first successful case of resection of the thoracic portion of the esophagus for carcinoma. Surg Gynecol Obst. 1913;16:614.

    Google Scholar 

  2. Turner G. Excision of thoracic oesophagus for carcinoma with construction of extra-thoracic gullet. Lancet. 1933;2:1315.

    Article  Google Scholar 

  3. Orringer MB, Sloan H. Esophagectomy without thoracotomy. J Thorac Cardiovasc Surg. 1978;76(5):643–54.

    CAS  PubMed  Google Scholar 

  4. Orringer MB, Lemmer JH. Early dilation in the treatment of esophageal disruption. Ann Thorac Surg. 1986;42(5):536–9.

    Article  CAS  PubMed  Google Scholar 

  5. Colvin H, Dunning J, Khan OA. Transthoracic versus transhiatal esophagectomy for distal esophageal cancer: which is superior? Interact Cardiovasc Thorac Surg. 2011;12(2):265–9.

    Article  PubMed  Google Scholar 

  6. Lewis I. The surgical treatment of carcinoma of the oesophagus; with special reference to a new operation for growths of the middle third. Br J Surg. 1946;34:18–31.

    Article  CAS  PubMed  Google Scholar 

  7. D’Amico TA. Mckeown esophagogastrectomy. J Thorac Dis. 2014;6(Suppl 3):S322–4.

    PubMed  PubMed Central  Google Scholar 

  8. McKeown KC. Trends in oesophageal resection for carcinoma with special reference to total oesophagectomy. Ann R Coll Surg Engl. 1972;51(4):213–39.

    CAS  PubMed  PubMed Central  Google Scholar 

  9. Bakhos CT, Fabian T, Oyasiji TO, Gautam S, Gangadharan SP, Kent MS, et al. Impact of the surgical technique on pulmonary morbidity after esophagectomy. Ann Thorac Surg. 2012;93(1):221–6; discussion 226–7

    Article  PubMed  Google Scholar 

  10. Raymond DP, Seder CW, Wright CD, Magee MJ, Kosinski AS, Cassivi SD, et al. Predictors of major morbidity or mortality after resection for esophageal cancer: a Society of Thoracic Surgeons general thoracic surgery database risk adjustment model. Ann Thorac Surg. 2016;102(1):207–14.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Sweet RH. Carcinoma of the esophagus and the cardiac end of the stomach immediate and late results of treatment by resection and primary esophagogastric anastomosis. J Am Med Assoc. 1947;135(8):485–90.

    Article  CAS  PubMed  Google Scholar 

  12. Zhang H, Wang J, Wang W, Zhou L, Chen J, Yang B, et al. A meta-analysis of esophagectomy: the comparative study of Ivor-Lewis operation and Sweet operation. Zhonghua Wei Chang Wai Ke Za Zhi. 2014;17(9):892–7.

    PubMed  Google Scholar 

  13. Matthews HR, Steel A. Left-sided subtotal oesophagectomy for carcinoma. Br J Surg. 1987;74(12):1115–7.

    Article  CAS  PubMed  Google Scholar 

  14. Palazzo F, Rosato EL, Chaudhary A, Evans NR 3rd, Sendecki JA, Keith S, et al. Minimally invasive esophagectomy provides significant survival advantage compared with open or hybrid esophagectomy for patients with cancers of the esophagus and gastroesophageal junction. J Am Coll Surg. 2015;220(4):672–9.

    Article  PubMed  Google Scholar 

  15. Zhou C, Zhang L, Wang H, Ma X, Shi B, Chen W, et al. Superiority of minimally invasive oesophagectomy in reducing in-hospital mortality of patients with resectable oesophageal cancer: a meta-analysis. PLoS One. 2015;10(7):e0132889.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Luketich JD, Pennathur A, Awais O, Levy RM, Keeley S, Shende M, et al. Outcomes after minimally invasive esophagectomy: review of over 1000 patients. Ann Surg. 2012;256(1):95–103.

    Article  PubMed  Google Scholar 

  17. Ben-David K, Kim T, Caban AM, Rossidis G, Rodriguez SS, Hochwald SN. Pre-therapy laparoscopic feeding jejunostomy is safe and effective in patients undergoing minimally invasive esophagectomy for cancer. J Gastrointest Surg. 2013;17(8):1352–8.

    Article  PubMed  Google Scholar 

  18. Park S, Hwang Y, Lee HJ, Park IK, Kim YT, Kang CH. Comparison of robot-assisted esophagectomy and thoracoscopic esophagectomy in esophageal squamous cell carcinoma. J Thorac Dis. 2016;8(10):2853–61.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Cerfolio RJ, Wei B, Hawn MT, Minnich DJ. Robotic esophagectomy for cancer: early results and lessons learned. Semin Thorac Cardiovasc Surg. 2016;28(1):160–9.

    Article  PubMed  Google Scholar 

  20. Yukaya T, Saeki H, Kasagi Y, Nakashima Y, Ando K, Imamura Y, et al. Indocyanine green fluorescence angiography for quantitative evaluation of gastric tube perfusion in patients undergoing esophagectomy. J Am Coll Surg. 2015;221(2):e37–42.

    Article  PubMed  Google Scholar 

  21. Hodari A, Park KU, Lace B, Tsiouris A, Hammoud Z. Robot-assisted minimally invasive Ivor Lewis esophagectomy with real-time perfusion assessment. Ann Thorac Surg. 2015;100(3):947–52.

    Article  PubMed  Google Scholar 

  22. Weksler B, Sharma P, Moudgill N, Chojnacki KA, Rosato EL. Robot-assisted minimally invasive esophagectomy is equivalent to thoracoscopic minimally invasive esophagectomy. Dis Esophagus. 2012;25(5):403–9.

    Article  CAS  PubMed  Google Scholar 

  23. Salami A, Abbas AE, Petrov R, Jhala N, Bakhos CT. Comparative analysis of clinical, treatment, and survival characteristics of basaloid and squamous cell carcinoma of the esophagus. J Am Coll Surg. 2018;226(6):1086–92.

    Article  PubMed  Google Scholar 

  24. Abbas AE, Dylewski MR. Robotic assisted minimally invasive esophagectomy. In: Kim KC, editor. Robotics in general surgery. New York: Springer; 2014. https://doi.org/10.1007/978-1-4614-8739-5_4.

    Chapter  Google Scholar 

  25. Fujita T, Iida Y, Tanaka C, Nakamura K, Yamanaka K, Ueno J, et al. Development and evaluation of an “interdisciplinary postoperative support program” in outpatient clinics after thoracic esophagectomy. Int J Surg. 2017;43:58–66.

    Article  PubMed  Google Scholar 

  26. Schmidt HM, Gisbertz SS, Moons J, Rouvelas I, Kauppi J, Brown A, et al. Defining benchmarks for transthoracic esophagectomy: a multicenter analysis of Total minimally invasive esophagectomy in low risk patients. Ann Surg. 2017;266(5):814–21.

    Article  PubMed  Google Scholar 

  27. Riber LP, Larsen TB, Christensen TD. Postoperative atrial fibrillation prophylaxis after lung surgery: systematic review and meta-analysis. Ann Thorac Surg. 2014;98(6):1989–97.

    Article  PubMed  Google Scholar 

  28. Berry MF, D’Amico TA, Onaitis MW. Use of amiodarone after major lung resection. Ann Thorac Surg. 2014;98(4):1199–206.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Zhao BC, Huang TY, Deng QW, Liu WF, Liu J, Deng WT, et al. Prophylaxis against atrial fibrillation after general thoracic surgery: trial sequential analysis and network meta-analysis. Chest. 2017;151(1):149–59.

    Article  PubMed  Google Scholar 

  30. Lerut T, Coosemans W, Decker G, De Leyn P, Nafteux P, van Raemdonck D. Anastomotic complications after esophagectomy. Dig Surg. 2002;19(2):92–8.

    Article  CAS  PubMed  Google Scholar 

  31. van den Berg MW, Kerbert AC, van Soest EJ, Schwartz MP, Bakker CM, Gilissen LP, et al. Safety and efficacy of a fully covered large-diameter self-expanding metal stent for the treatment of upper gastrointestinal perforations, anastomotic leaks, and fistula. Dis Esophagus. 2016;29(6):572–9.

    Article  PubMed  Google Scholar 

  32. Sutcliffe RP, Forshaw MJ, Tandon R, Rohatgi A, Strauss DC, Botha AJ, et al. Anastomotic strictures and delayed gastric emptying after esophagectomy: incidence, risk factors and management. Dis Esophagus. 2008;21(8):712–7.

    Article  CAS  PubMed  Google Scholar 

  33. Dickinson KJ, Blackmon SH. Management of conduit necrosis following esophagectomy. Thorac Surg Clin. 2015;25(4):461–70.

    Article  PubMed  Google Scholar 

  34. Schaheen L, Blackmon SH, Nason KS. Optimal approach to the management of intrathoracic esophageal leak following esophagectomy: a systematic review. Am J Surg. 2014;208(4):536–43.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Sharaiha RZ, Kumta NA, DeFilippis EM, Dimaio CJ, Gonzalez S, Gonda T, et al. A large multicenter experience with endoscopic suturing for management of gastrointestinal defects and stent anchorage in 122 patients: a retrospective review. J Clin Gastroenterol. 2016;50(5):388–92.

    PubMed  Google Scholar 

  36. Sarkaria IS, Rizk NP, Finley DJ, Bains MS, Adusumilli PS, Huang J, et al. Combined thoracoscopic and laparoscopic robotic-assisted minimally invasive esophagectomy using a four-arm platform: experience, technique and cautions during early procedure development. Eur J Cardiothorac Surg. 2013;43(5):e107–15.

    Article  PubMed  Google Scholar 

  37. Morita M, Saeki H, Okamoto T, Oki E, Yoshida S, Maehara Y. Tracheobronchial fistula during the perioperative period of esophagectomy for esophageal cancer. World J Surg. 2015;39(5):1119–26.

    Article  PubMed  Google Scholar 

  38. Arnold PG, Pairolero PC. Intrathoracic muscle flaps. An account of their use in the management of 100 consecutive patients. Ann Surg. 1990;211(6):656–60; discussion 660–2

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  39. Koshenkov VP, Yakoub D, Livingstone AS, Franceschi D. Tracheobronchial injury in the setting of an esophagectomy for cancer: postoperative discovery a bad omen. J Surg Oncol. 2014;109(8):804–7.

    Article  PubMed  Google Scholar 

  40. Shen Y, Feng M, Khan MA, Wang H, Tan L, Wang Q. A simple method minimizes chylothorax after minimally invasive esophagectomy. J Am Coll Surg. 2014;218(1):108–12.

    Article  PubMed  Google Scholar 

  41. Crucitti P, Mangiameli G, Petitti T, Condoluci A, Rocco R, Gallo IF, et al. Does prophylactic ligation of the thoracic duct reduce chylothorax rates in patients undergoing oesophagectomy? A systematic review and meta-analysis. Eur J Cardiothorac Surg. 2016;50(6):1019–24.

    Article  PubMed  Google Scholar 

  42. Pillay TG, Singh B. A review of traumatic chylothorax. Injury. 2016;47(3):545–50.

    Article  CAS  PubMed  Google Scholar 

  43. Cope C, Salem R, Kaiser LR. Management of chylothorax by percutaneous catheterization and embolization of the thoracic duct: prospective trial. J Vasc Interv Radiol. 1999;10(9):1248–54.

    Article  CAS  PubMed  Google Scholar 

  44. Sato Y, Kosugi S, Aizawa N, Ishikawa T, Kano Y, Ichikawa H, et al. Risk factors and clinical outcomes of recurrent laryngeal nerve paralysis after Esophagectomy for thoracic esophageal carcinoma. World J Surg. 2016;40(1):129–36.

    Article  PubMed  Google Scholar 

  45. Wright CD, Zeitels SM. Recurrent laryngeal nerve injuries after esophagectomy. Thorac Surg Clin. 2006;16(1):23–33. v

    Article  PubMed  Google Scholar 

  46. Antonoff MB, Puri V, Meyers BF, Baumgartner K, Bell JM, Broderick S, et al. Comparison of pyloric intervention strategies at the time of esophagectomy: is more better? Ann Thorac Surg. 2014;97(6):1950–7; discussion 1657–8

    Article  PubMed Central  PubMed  Google Scholar 

  47. Arya S, Markar SR, Karthikesalingam A, Hanna GB. The impact of pyloric drainage on clinical outcome following esophagectomy: a systematic review. Dis Esophagus. 2015;28(4):326–35.

    Article  CAS  PubMed  Google Scholar 

  48. Manfredi MA. Endoscopic management of anastomotic esophageal strictures secondary to esophageal atresia. Gastrointest Endosc Clin N Am. 2016;26(1):201–19.

    Article  PubMed  Google Scholar 

  49. Kinoshita Y, Udagawa H, Tsutsumi K, Ueno M, Mine S, Ehara K. Surgical repair of refractory strictures of esophagogastric anastomoses caused by leakage following esophagectomy. Dis Esophagus. 2009;22(5):427–33.

    Article  CAS  PubMed  Google Scholar 

  50. Williams VA, Watson TJ, Zhovtis S, Gellersen O, Raymond D, Jones C, et al. Endoscopic and symptomatic assessment of anastomotic strictures following esophagectomy and cervical esophagogastrostomy. Surg Endosc. 2008;22(6):1470–6.

    Article  CAS  PubMed  Google Scholar 

  51. Kochhar R, Makharia GK. Usefulness of intralesional triamcinolone in treatment of benign esophageal strictures. Gastrointest Endosc. 2002;56(6):829–34.

    Article  PubMed  Google Scholar 

  52. Vallbohmer D, Holscher AH, Herbold T, Gutschow C, Schroder W. Diaphragmatic hernia after conventional or laparoscopic-assisted transthoracic esophagectomy. Ann Thorac Surg. 2007;84(6):1847–52.

    Article  PubMed  Google Scholar 

  53. Kent MS, Luketich JD, Tsai W, Churilla P, Federle M, Landreneau R, et al. Revisional surgery after esophagectomy: an analysis of 43 patients. Ann Thorac Surg. 2008;86(3):975–83; discussion 967–74

    Article  PubMed  Google Scholar 

  54. Sutherland J, Banerji N, Morphew J, Johnson E, Dunn D. Postoperative incidence of incarcerated hiatal hernia and its prevention after robotic transhiatal esophagectomy. Surg Endosc. 2011;25(5):1526–30.

    Article  PubMed  Google Scholar 

  55. Malik Z, Kataria R, Modayil R, Ehrlich AC, Schey R, Parkman HP, et al. Gastric per oral endoscopic myotomy (G-POEM) for the treatment of refractory gastroparesis: early experience. Dig Dis Sci (2018). https://doi.org/10.1007/s10620-018-4976-9.

    Article  PubMed  Google Scholar 

  56. Rove JY, Krupnick AS, Baciewicz FA, Meyers BF. Gastric conduit revision postesophagectomy: management for a rare complication. J Thorac Cardiovasc Surg. 2017;154(4):1450–8.

    Article  PubMed  Google Scholar 

  57. Lee P, Kupeli E, Mehta AC. Airway stents. Clin Chest Med. 2010;31(1):141–50. Table of Contents

    Article  CAS  PubMed  Google Scholar 

  58. Dunn LJ, Shenfine J, Griffin SM. Columnar metaplasia in the esophageal remnant after esophagectomy: a systematic review. Dis Esophagus. 2015;28(1):32–41.

    Article  CAS  PubMed  Google Scholar 

  59. El-Serag HB, Naik AD, Duan Z, Shakhatreh M, Helm A, Pathak A, et al. Surveillance endoscopy is associated with improved outcomes of oesophageal adenocarcinoma detected in patients with Barrett's oesophagus. Gut. 2016;65(8):1252–60.

    Article  PubMed  Google Scholar 

  60. Gasparri MG, Tisol WB, Haasler GB. Roux-en-Y diversion for debilitating reflux after esophagectomy. Am Surg. 2005;71(8):687–9.

    PubMed  Google Scholar 

  61. Schieman C, Wigle DA, Deschamps C, Nichols FC 3rd, Cassivi SD, Shen KR, et al. Salvage resections for recurrent or persistent cancer of the proximal esophagus after chemoradiotherapy. Ann Thorac Surg. 2013;95(2):459–63.

    Article  PubMed  Google Scholar 

  62. Schipper PH, Cassivi SD, Deschamps C, Rice DC, Nichols FC 3rd, Allen MS, et al. Locally recurrent esophageal carcinoma: when is re-resection indicated? Ann Thorac Surg. 2005;80(3):1001–5; discussion 1005–6

    Article  PubMed  Google Scholar 

  63. Knabe M, May A, Ell C. Endoscopic resection for patients with mucosal adenocarcinoma of the esophagus. Minerva Gastroenterol Dietol. 2016;62(4):281–95.

    PubMed  Google Scholar 

  64. Bodner J, Wykypiel H, Wetscher G, Schmid T. First experiences with the da Vinci operating robot in thoracic surgery. Eur J Cardiothorac Surg. 2004;25(5):844–51.

    Article  CAS  PubMed  Google Scholar 

  65. Kernstine KH, DeArmond DT, Shamoun DM, Campos JH. The first series of completely robotic esophagectomies with three-field lymphadenectomy: initial experience. Surg Endosc. 2007;21(12):2285–92.

    Article  CAS  PubMed  Google Scholar 

  66. Trugeda Carrera MS, Fernandez-Diaz MJ, Rodriguez-Sanjuan JC, Manuel-Palazuelos JC, de Diego Garcia EM, Gomez-Fleitas M. Initial results of robotic esophagectomy for esophageal cancer. Cir Esp. 2015;93(6):396–402.

    Article  PubMed  Google Scholar 

  67. Park SY, Kim DJ, Do YW, Suh J, Lee S. The oncologic outcome of esophageal squamous cell carcinoma patients after robot-assisted thoracoscopic esophagectomy with total mediastinal lymphadenectomy. Ann Thorac Surg. 2017;103(4):1151–7.

    Article  PubMed  Google Scholar 

  68. Amaral M, Pimiento J, Fontaine JP. Robotic esophagectomy: the Moffitt Cancer Center experience. Ann Cardiothorac Surg. 2017;6(2):186–9.

    Article  PubMed Central  PubMed  Google Scholar 

  69. van der Sluis PC, Ruurda JP, van der Horst S, Verhage RJ, Besselink MG, Prins MJ, et al. Robot-assisted minimally invasive thoraco-laparoscopic esophagectomy versus open transthoracic esophagectomy for resectable esophageal cancer, a randomized controlled trial (ROBOT trial). Trials. 2012;13:230. https://doi.org/10.1186/1745-6215-13-230.

    Article  PubMed  PubMed Central  Google Scholar 

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Petrov, R.V., Bakhos, C.T., Abbas, A.E. (2019). Robotic Esophagectomy. In: Tsuda, S., Kudsi, O. (eds) Robotic-Assisted Minimally Invasive Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-96866-7_34

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  • DOI: https://doi.org/10.1007/978-3-319-96866-7_34

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