| Background: We developed a hybrid of the prone and left lateral decubitus positions for thoracoscopic esophagectomy with extensive lymph node dissection (TE). In June 2018, we introduced robot-assisted esophagectomy (RE) using daVinci Xi system. Method: One-hundred ninety one ESCC patients who underwent TE between Jan/2009 and Dec/2016, and 20 patients who underwent RE between Jun/2018 to Feb/2020, were retrospectively reviewed. We also reviewed short time outcome of RE and compared to 56 TE performed in the same period. Results: The number of patients classified with postoperative pathological stage of 0/1/2/3/4 was 5(3%)/70(37%)/48(26%)/49(27%)/19(7%), respectively. Three years RFS with clinical stage of 1/2/3+4 was 91.5%/54.8%/51.9%, respectively. In June 2018, we introduced RE. Average operation time in the thoracic procedure of TE and RE was 227min and 305min, average blood loss was 10ml and 7.5ml, postoperative hospital stay 32days and 22days (P=0.036) respectively. The incidence of anastomotic leakage of TE and RE was 7.1% and 5%, vocal cord palsy was 8.9% and 5%, and oral intake within 14POD was 48.2% and 75% (p=0.039) respectively. Conclusions: TE with a hybrid position is thought to be feasible and effective methods. RE was safely introduced in our facility and it is feasible and beneficial for the lymph node dissection especially around the recurrent laryngeal nerve, and result in earlier oral intake and shorter hospital stay. |
