Anatomical factor associated with thoracic procedural difficulty in robot-assisted minimally invasive esophagectomy.
Langenbecks Arch Surg
; 409(1): 190, 2024 Jun 19.
Article
en En
| MEDLINE
| ID: mdl-38896339
ABSTRACT
BACKGROUND:
Robotic surgical systems with full articulation of instruments, tremor filtering, and motion scaling can potentially overcome the procedural difficulties in endoscopic surgeries. However, whether robot-assisted minimally invasive esophagectomy (RAMIE) can overcome anatomical difficulties during thoracoscopic esophagectomy remains unclear. This study aimed to clarify the anatomical and clinical factors that influence the difficulty of RAMIE in the thoracic region.METHODS:
Forty-five patients who underwent curative-intent RAMIE with upper mediastinal lymph node dissection for esophageal cancer were included. Using preoperative computed tomography images, we calculated previously reported anatomical indices to assess the upper mediastinal narrowness and vertebral body projections in the middle thoracic region. The factors influencing thoracic operative time were then investigated.RESULTS:
During the thoracic procedure, the median operative time was 215 (124-367) min and the median blood loss was 20 (5-190) mL. Postoperatively, pneumonia, anastomotic leakage, and recurrent laryngeal nerve palsy occurred in 17.8%, 2.2%, and 6.7% of the patients, respectively. The multiple linear regression model revealed that a narrow upper mediastinum and greater blood loss during the thoracic procedure were significant factors associated with a prolonged thoracic operative time (P = 0.025 and P < 0.001, respectively). Upper mediastinal narrowing was not associated with postoperative complications.CONCLUSIONS:
A narrow upper mediastinum was significantly associated with a prolonged thoracic operative time in patients with RAMIE.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Toracoscopía
/
Neoplasias Esofágicas
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Esofagectomía
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Tempo Operativo
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Procedimientos Quirúrgicos Robotizados
/
Escisión del Ganglio Linfático
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Langenbecks Arch Surg
Año:
2024
Tipo del documento:
Article
País de afiliación:
Japón