Minimally invasive and robotic surgery in the surgical treatment of esophagogastric junction cancer
Cir Esp (Engl Ed). 2019 Oct;97(8):451-458.
doi: 10.1016/j.ciresp.2019.03.013.
Epub 2019 Apr 29.
[Article in
English,
Spanish]
Authors
Ismael Díez Del Val
1
, Carlos Loureiro González
2
, José Ignacio Asensio Gallego
3
, Carla Bettonica Larrañaga
4
, Saioa Leturio Fernández
2
, Emma Eizaguirre Letamendia
3
, Mónica Miró Martín
4
, Marta María García Fernández
2
, Laura Martí Gelonch
3
, Humberto Aranda Danso
4
, Julen Barrenetxea Asua
2
, Fernando Estremiana García
4
, Javier Ortiz Lacorzana
2
, Leandre Farran Teixidó
4
Affiliations
- 1 Sección de Cirugía esofagogástrica, Hospital Universitario Basurto, Bilbao, España. Electronic address: ismael.diezdelval@osakidetza.eus.
- 2 Sección de Cirugía esofagogástrica, Hospital Universitario Basurto, Bilbao, España.
- 3 Sección de Cirugía esofagogástrica, Hospital Universitario Donostia, Donostia-San Sebastián, España.
- 4 Sección de Cirugía esofagogástrica, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
Abstract
Minimally invasive surgery provides for the treatment of esophagogastric junction tumors under safe conditions, reducing respiratory and abdominal wall complications. Recovery is improved, while maintaining the oncological principles of surgery to obtain an optimal long-term outcome. It is important to have a sufficient volume of activity to progress along the learning curve with close expert supervision in order to guarantee R0 resection and adequate lymphadenectomy. Minimal invasiveness ought not become an objective in itself. Should total gastrectomy be performed, the risk of a positive proximal margin makes intraoperative biopsy compulsory, without ruling out a primary open approach. Meanwhile, minimally invasive esophagectomy has been gaining ground. Its main difficulty, the intrathoracic anastomosis, can be safely carried out either with a mechanical side-to-side suture or a robot-assisted manual suture, thanks to the 3-D vision and versatility of the instruments.
Keywords:
Cirugía mínimamente invasiva; Cirugía robótica; Esofagectomía; Esophagectomy; Esophagogastric junction; Gastrectomy; Gastrectomía; Minimally invasive surgery; Robotic surgery; Unión esofagogástrica.
Copyright © 2019 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.
MeSH terms
-
Anastomosis, Surgical / methods
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Barrett Esophagus / pathology
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Esophageal Neoplasms / diagnostic imaging
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Esophageal Neoplasms / pathology
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Esophageal Neoplasms / surgery*
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Esophagectomy / methods*
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Esophagogastric Junction / diagnostic imaging
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Esophagogastric Junction / pathology
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Esophagogastric Junction / surgery*
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Esophagoscopy
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Gastrectomy / methods*
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Humans
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Laparoscopy
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Lymph Node Excision / methods
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Neoplasm Invasiveness
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Positron Emission Tomography Computed Tomography
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Postoperative Complications / prevention & control
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Robotic Surgical Procedures*
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Stomach Neoplasms / pathology
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Stomach Neoplasms / surgery*