Journal of Chest Surgery

  • 제54권4호
  • /
  • Pages.294-301
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  • 2021
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
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Robot-Assisted Thoracoscopic Esophagectomy with Total Mediastinal Lymphadenectomy: A Guide to a Systematic Approach Using the Concept of Fascial Plane Dissection

  • Park, Byung Jo (Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine) ;
  • Kim, Dae Joon (Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine)
  • 투고 : 2021.06.14
  • 심사 : 2021.07.02
  • 발행 : 2021.08.05
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초록

Recent case series and meta-analyses have suggested that robot-assisted minimally invasive esophagectomy (RAMIE) could be a useful alternative to video-assisted thoracic surgery esophagectomy. The advantages of RAMIE are a 3-dimensional view, 7 degrees of freedom, and tremor filtering, which enable more meticulous lymph node dissection with a lower incidence of complications. However, in radical esophagectomy, understanding the concepts of the fascia and compartment is crucial for successful and reliable dissection. The first RAMIE in Korea was performed by our team in July 2006, and since then, we have developed related techniques to achieve better short- and long-term outcomes. The key step in RAMIE for esophageal squamous cell carcinoma is dissection of the upper mediastinum due to the difficulty of lymph node dissection and the high incidence of nodal metastasis in the area. Herein, we describe the technique of fascial plane dissection with esophageal suspension during RAMIE.

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참고문헌

  1. Van Hillegersberg R, Boone J, Draaisma WA, Broeders IA, Giezeman MJ, Borel Rinkes IH. First experience with robot-assisted thoracoscopic esophagolymphadenectomy for esophageal cancer. Surg Endosc 2006;20:1435-9. https://doi.org/10.1007/s00464-005-0674-8
  2. Galvani CA, Gorodner MV, Moser F, et al. Robotically assisted laparoscopic transhiatal esophagectomy. Surg Endosc 2008;22:188-95. https://doi.org/10.1007/s00464-007-9441-3
  3. Espat NJ, Jacobsen G, Horgan S, Donahue P. Minimally invasive treatment of esophageal cancer: laparoscopic staging to robotic esophagectomy. Cancer J 2005;11:10-7. https://doi.org/10.1097/00130404-200501000-00003
  4. 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;25:403-9. https://doi.org/10.1111/j.1442-2050.2011.01246.x
  5. Kim DJ, Park SY, Lee S, Kim HI, Hyung WJ. Feasibility of a robot-assisted thoracoscopic lymphadenectomy along the recurrent laryngeal nerves in radical esophagectomy for esophageal squamous carcinoma. Surg Endosc 2014;28:1866-73. https://doi.org/10.1007/s00464-013-3406-5
  6. Park SY, Kim DJ, Yu WS, Jung HS. Robot-assisted thoracoscopic esophagectomy with extensive mediastinal lymphadenectomy: experience with 114 consecutive patients with intrathoracic esophageal cancer. Dis Esophagus 2016;29:326-32. https://doi.org/10.1111/dote.12335
  7. Park SY, Kim DJ, Kang DR, Haam SJ. Learning curve for robotic esophagectomy and dissection of bilateral recurrent laryngeal nerve nodes for esophageal cancer. Dis Esophagus 2017;30:1-9.
  8. 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;103:1151-7. https://doi.org/10.1016/j.athoracsur.2016.09.037
  9. Kim DJ, Park SY, Hong MH. Korean experiences of the treatment of esophageal squamous cell carcinoma. In: Ando N, editor. Esophageal squamous cell carcinoma: diagnosis and treatment. 2nd ed. Singapore: Springer Nature Singapore Pte Ltd.; 2020. p. 363-76.
  10. Ding X, Zhang J, Li B, et al. A meta-analysis of lymph node metastasis rate for patients with thoracic oesophageal cancer and its implication in delineation of clinical target volume for radiation therapy. Br J Radiol 2012;85:e1110-9. https://doi.org/10.1259/bjr/12500248
  11. Wang Y, Zhu L, Xia W, Wang F. Anatomy of lymphatic drainage of the esophagus and lymph node metastasis of thoracic esophageal cancer. Cancer Manag Res 2018;10:6295-303. https://doi.org/10.2147/CMAR.S182436
  12. Tachimori Y, Nagai Y, Kanamori N, Hokamura N, Igaki H. Pattern of lymph node metastases of esophageal squamous cell carcinoma based on the anatomical lymphatic drainage system. Dis Esophagus 2011;24:33-8. https://doi.org/10.1111/j.1442-2050.2010.01086.x
  13. Park SY, Suh JW, Kim DJ, et al. Near-infrared lymphatic mapping of the recurrent laryngeal nerve nodes in T1 esophageal cancer. Ann Thorac Surg 2018;105:1613-20. https://doi.org/10.1016/j.athoracsur.2018.01.083
  14. McKeown KC. Trends in oesophageal resection for carcinoma with special reference to total oesophagectomy. Ann R Coll Surg Engl 1972;51:213-39.
  15. D'Amico TA. Mckeown esophagogastrectomy. J Thorac Dis 2014;6(Suppl 3):S322-4.
  16. Suda K, Ishida Y, Kawamura Y, et al. 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. World J Surg 2012;36:1608-16. https://doi.org/10.1007/s00268-012-1538-8