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Salvage Robotic-Assisted Thoracoscopic Esophagectomy after Definitive Chemoradiotherapy for Clinical T4b Esophageal Cancer: A Case Report

The advantages of salvage esophagectomy through robotic-assisted surgery for patients with clinically diagnosed tumor invasion of adjacent vital organs (cT4b) or patients with scar tissue from definitive chemoradiotherapy (dCRT) are still only rarely reported. A man in his 60s with middle thoracic e...

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Autores principales: Sasamori, Ryohei, Motoyama, Satoru, Sato, Yusuke, Wakita, Akiyuki, Nagaki, Yushi, Imai, Kazuhiro, Minamiya, Yoshihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126768/
https://www.ncbi.nlm.nih.gov/pubmed/34866120
http://dx.doi.org/10.5761/atcs.cr.21-00175
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author Sasamori, Ryohei
Motoyama, Satoru
Sato, Yusuke
Wakita, Akiyuki
Nagaki, Yushi
Imai, Kazuhiro
Minamiya, Yoshihiro
author_facet Sasamori, Ryohei
Motoyama, Satoru
Sato, Yusuke
Wakita, Akiyuki
Nagaki, Yushi
Imai, Kazuhiro
Minamiya, Yoshihiro
author_sort Sasamori, Ryohei
collection PubMed
description The advantages of salvage esophagectomy through robotic-assisted surgery for patients with clinically diagnosed tumor invasion of adjacent vital organs (cT4b) or patients with scar tissue from definitive chemoradiotherapy (dCRT) are still only rarely reported. A man in his 60s with middle thoracic esophageal cancer (cT4b [left main bronchus] N1 M0 cStage IIIC) received dCRT (60 Gy). After the chemoradiotherapy, upper gastrointestinal endoscopy revealed a residual primary tumor, and we performed robotic-assisted thoracoscopic subtotal esophagectomy and gastric tube reconstruction via a retrosternal route with three-field lymphadenectomy. Although it was difficult to dissect the tumor from adjacent organs, especially the left main bronchus and left inferior pulmonary vein, due to loss of the dissecting layer and scarring, R0 surgery was achieved. With robot-assisted thoracoscopic surgery, the high-magnification, high-resolution, and three-dimensional images; the stable surgical field with full countertraction made with the robotic arm forceps, which were readily adjusted; and the stable motion of the robotic arm without physiological tremor are considerable advantages for salvage esophagectomy for cT4b tumors. It goes without saying that sufficient experience with robot-assisted surgery and sufficient understanding and surgical skill in esophageal cancer surgery under suitable surgical indications and timing are required to make use of these advantages.
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spelling pubmed-101267682023-04-26 Salvage Robotic-Assisted Thoracoscopic Esophagectomy after Definitive Chemoradiotherapy for Clinical T4b Esophageal Cancer: A Case Report Sasamori, Ryohei Motoyama, Satoru Sato, Yusuke Wakita, Akiyuki Nagaki, Yushi Imai, Kazuhiro Minamiya, Yoshihiro Ann Thorac Cardiovasc Surg Case Report The advantages of salvage esophagectomy through robotic-assisted surgery for patients with clinically diagnosed tumor invasion of adjacent vital organs (cT4b) or patients with scar tissue from definitive chemoradiotherapy (dCRT) are still only rarely reported. A man in his 60s with middle thoracic esophageal cancer (cT4b [left main bronchus] N1 M0 cStage IIIC) received dCRT (60 Gy). After the chemoradiotherapy, upper gastrointestinal endoscopy revealed a residual primary tumor, and we performed robotic-assisted thoracoscopic subtotal esophagectomy and gastric tube reconstruction via a retrosternal route with three-field lymphadenectomy. Although it was difficult to dissect the tumor from adjacent organs, especially the left main bronchus and left inferior pulmonary vein, due to loss of the dissecting layer and scarring, R0 surgery was achieved. With robot-assisted thoracoscopic surgery, the high-magnification, high-resolution, and three-dimensional images; the stable surgical field with full countertraction made with the robotic arm forceps, which were readily adjusted; and the stable motion of the robotic arm without physiological tremor are considerable advantages for salvage esophagectomy for cT4b tumors. It goes without saying that sufficient experience with robot-assisted surgery and sufficient understanding and surgical skill in esophageal cancer surgery under suitable surgical indications and timing are required to make use of these advantages. The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery 2021-12-03 2023 /pmc/articles/PMC10126768/ /pubmed/34866120 http://dx.doi.org/10.5761/atcs.cr.21-00175 Text en ©2023 Annals of Thoracic and Cardiovascular Surgery https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Case Report
Sasamori, Ryohei
Motoyama, Satoru
Sato, Yusuke
Wakita, Akiyuki
Nagaki, Yushi
Imai, Kazuhiro
Minamiya, Yoshihiro
Salvage Robotic-Assisted Thoracoscopic Esophagectomy after Definitive Chemoradiotherapy for Clinical T4b Esophageal Cancer: A Case Report
title Salvage Robotic-Assisted Thoracoscopic Esophagectomy after Definitive Chemoradiotherapy for Clinical T4b Esophageal Cancer: A Case Report
title_full Salvage Robotic-Assisted Thoracoscopic Esophagectomy after Definitive Chemoradiotherapy for Clinical T4b Esophageal Cancer: A Case Report
title_fullStr Salvage Robotic-Assisted Thoracoscopic Esophagectomy after Definitive Chemoradiotherapy for Clinical T4b Esophageal Cancer: A Case Report
title_full_unstemmed Salvage Robotic-Assisted Thoracoscopic Esophagectomy after Definitive Chemoradiotherapy for Clinical T4b Esophageal Cancer: A Case Report
title_short Salvage Robotic-Assisted Thoracoscopic Esophagectomy after Definitive Chemoradiotherapy for Clinical T4b Esophageal Cancer: A Case Report
title_sort salvage robotic-assisted thoracoscopic esophagectomy after definitive chemoradiotherapy for clinical t4b esophageal cancer: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126768/
https://www.ncbi.nlm.nih.gov/pubmed/34866120
http://dx.doi.org/10.5761/atcs.cr.21-00175
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