| 【Background】There is insufficient evidence to support the superiority of robot-assisted thoracoscopic esophagectomy (RATE) over conventional thoracoscopic esophagectomy (TE). We began RATE for esophageal cancer since 2014. We have reported superiority of upper mediastinal lymph node dissection over TE.【Method】A pilot study was conducted to determine whether RATE is superior to conventional TE for mid to long term surgical results.【Results】There were 42 cases of thoracic esophageal cancer. Median age: 65.5, male/female: 38/4. Tumor histology (SCC/NEC/melanoma/carcinosarcoma): 39/1/1/1, tumor site (Ut/Mt/Lt): 9/18/15, cStage (I/II/III/IV): 11/14/14/3. Preoperative neoadjuvant treatment (surgery alone/CRT): 15/27, LN dissection (2-field/3-field): 2/40. Median number of harvested LNs (around Lt. RLN/mediastinal): 5/22. Although there were no significant differences, RATE tended to have more harvested LNs compared with TE cases. Regional LN recurrence was not observed in RATE, but was observed in 3 cases in TE. Regarding 3-year OS, cStage I/II-III was 91% and 67% for RATE, and 90% and 76% for TE. There were 6 cases of esophagogastric junction cancer. cStage (I/II/III): 3/2/1, preoperative neoadjuvant treatment (surgery alone/CT/CRT): 4/1/1. Of the 6 cases, one died of cancer (distant metastasis), and the other 5 are relapse-free. There are no regional LN recurrences.【Conclusion】At this time, the superiority of RATE to esophageal and esophagogastric junction cancers could not be demonstrated. Analysis results of the data accumulated after the stage when the surgical procedure is stabilized are expected. |
