Two Cases of Robot-Assisted Totally Minimally Invasive Esophagectomy with Colon Interposition for Gastroesophageal Junction Cancer: Surgical Considerations

J Chest Surg. 2024 May 5;57(3):323-327. doi: 10.5090/jcs.23.131. Epub 2024 Feb 7.

Abstract

This case report presents 2 patients with gastroesophageal junction cancer who both underwent totally minimally invasive esophagectomy with colon interposition. Patients 1 and 2, who were 43-year-old and 78-year-old men, respectively, had distinct clinical presentations and medical histories. Patient 1 underwent minimally invasive robotic esophagectomy with a laparoscopic total gastrectomy, colonic conduit preparation, and intrathoracic esophago-colono-jejunostomy. Patient 2 underwent completely robotic total gastrectomy, colon conduit preparation, and intrathoracic esophago-colono-jejunostomy. The primary challenge in colon interposition is assessing colon vascularity and ensuring an adequate conduit length, which is critical for successful anastomosis. In both cases, we used indocyanine green fluorescence angiography to evaluate vascularity. Determining the appropriate conduit is challenging; therefore, it is crucial to ensure a slightly longer conduit during reconstruction. Because totally minimally invasive colon interposition can reduce postoperative pain and enhance recovery, this surgical technique is feasible and beneficial.

Keywords: Case reports; Colon interposition; Minimally invasive surgical procedures; Robotic surgical procedures.

Publication types

  • Case Reports

Grants and funding

Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.