Robotic Esophagectomy
摘要
Esophageal cancer ranks as the ninth most prevalent malignancy globally and stands as the sixth principal cause of cancer-related mortality. The escalating incidence of this disease primarily involves two predominant histological types: squamous cell carcinoma and adenocarcinoma. While squamous cell carcinoma remains the prevailing form on a global scale, Western nations are witnessing a decline in its occurrence but a noteworthy surge in adenocarcinomas, including those occurring at the esophagogastric junction. Surgical intervention is the cornerstone of curative therapeutic approaches and is usually accompanied by multimodal treatments such as perioperative chemotherapy, preoperative chemoradiation, and adjuvant chemotherapy, resulting in 5-year survival rates surpassing 45%. Despite the success of oncological treatments, emphasis is placed on the safety of the surgical procedures. Esophageal resection imposes a substantial surgical trauma for the patient and has a high incidence of morbidity with substantial mortality worldwide. Minimally invasive techniques for esophageal resection, including fully minimally invasive and robotic-assisted procedures, have emerged to reduce the trauma and complications associated with open surgery. Today, they are widely acknowledged as safe options with established oncological efficacy. Recent studies suggest additional advantages of fully minimally invasive and robotic-assisted minimally invasive esophagectomy in terms of postoperative morbidity. To date, there is no clear consensus regarding the optimal operative technique for an esophageal resection. The data arising from two Asian randomized controlled trials, which compared the two fully minimally invasive techniques, suggest some benefits for the robotic-assisted procedures, particularly in the safety of lymphadenectomy of the upper mediastinum. Ongoing research and continuous technological advancements in current and new robotic systems coupled with innovative surgical processes hold the potential to revolutionize the existing standards.