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Background: Open transthoracic esophagectomy is the worldwide gold standard in the treatment of resectable esophageal cancer. Robot-assisted minimally invasive thoraco-laparoscopic esophagectomy (RAMIE) for esophageal cancer may be associated with reduced blood loss, shorter intensive care unit (ICU) stay, and less cardiopulmonary morbidity; however, long-term oncologic results have not been reported to date. Methods: Between June 2007 and September 2011, a total of 108 patients with potentially resectable esophageal cancer underwent RAMIE at the University Medical Centre Utrecht, with curative intent. All data were recorded prospectively. Results: Median duration of the surgical procedure was 381 min (range 264–636). Pulmonary complications were most common and were observed in 36 patients (33 %). Median ICU stay was 1 day, and median overall postoperative hospital stay was 16 days. In-hospital mortality was 5 %. The majority of patients (78 %) presented with T3 and T4 disease, and 68 % of patients had nodal-positive disease (cN1–3). In 65 % of patients, neoadjuvant treatment (chemotherapy 57 %, chemoradiotherapy 7 %, radiotherapy 1 %) was administered, and in 103 (95 %) patients, a radical resection (R0) was achieved. The median number of lymph nodes was 26, median follow-up was 58 months, 5-year overall survival was 42 %, median disease-free survival was 21 months, and median overall survival was 29 months. Tumor recurrence occurred in 51 patients and was locoregional only in 6 (6 %) patients, systemic only in 31 (30 %) patients, and combined in 14 (14 %) patients. Conclusion: RAMIE was shown to be oncologically effective, with a high percentage of R0 radical resections and adequate lymphadenectomy. RAMIE provided good local control with a low percentage of local recurrence at long-term follow up.




P.C., van der S., J.P., R., R.J.J., V., S., van der H., L., H., P.D., S., … R., van H. (2015). Oncologic Long-Term Results of Robot-Assisted Minimally Invasive Thoraco-Laparoscopic Esophagectomy with Two-Field Lymphadenectomy for Esophageal Cancer. Annals of Surgical Oncology, 22, 1350–1356. https://doi.org/10.1245/s10434-015-4544-x LK  - http://sfx.library.uu.nl/utrecht?sid=EMBASE&issn=15344681&id=doi:10.1245%2Fs10434-015-4544-x&atitle=Oncologic+Long-Term+Results+of+Robot-Assisted+Minimally+Invasive+Thoraco-Laparoscopic+Esophagectomy+with+Two-Field+Lymphadenectomy+for+Esophageal+Cancer&stitle=Ann.+Surg.+Oncol.&title=Annals+of+Surgical+Oncology&volume=22&issue=&spage=1350&epage=1356&aulast=van+der+Sluis&aufirst=P.C.&auinit=P.C.&aufull=van+der+Sluis+P.C.&coden=ASONF&isbn=&pages=1350-1356&date=2015&a

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