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Robot-assisted IVOR-LEWIS Esophagectomy

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Ruijin Hospital

キーワード

概要

Minimally invasive esophagectomy (MIE) have become increasingly popular in esophageal cancer. It is generally accepted that comparing to open resections, MIE results in decreased postoperative pain, faster recovery times, and shorter hospital stays with comparable oncologic outcomes. However, MIE poses an important challenge for established thoracic surgeons as it is a difficult technique to become skilled at with an protracted learning curve. Standard laparoscopic and thoracoscopic instruments are rigid and provide a finite freedom of movement with a two dimensional visualization of the operating field. Such a difficulty is increased even more when the Ivor-Lewis esophagectomy with an intrathoracic anastomosis is needed.
Robot- assisted surgical system has opened a new era of minimally invasive surgery. Robot- assisted surgery offers some advantages including high- definition three- dimensional visualization and 7 degrees of freedom with the use of its surgical wrists, motion scaling, and tremor filtration, allowing the surgeon to perform complex operations comfortably in the domain of urinary tract, hepatobiliary and gynecological surgery. Although a robot-assisted thoraco- laparoscopic minimally invasive esophagectomy (RAMIE) was initiated from 2003, the published experience with RAMIE remains small, especially for Ivor- Lewis approaches. The aim of this study was to investigate the short- term and long-term outcomes of RAILE to identify any clinical or oncologic benefits of RAILE in esophageal cancer.

説明

This confirmatory, nonrandomized, single-arm trial (phase II) will be conducted to evaluate short-and long-term outcomes of robot-assisted thoraco- laparoscopic minimally invasive esophagectomy for esophageal cancer. Patients will registered preoperatively. The planned sample size was 51. Preoperative endoscopic biopsy was performed in all patients to confirm the histological diagnosis of esophageal cancer. Staging workup included thorough history and physical examination, esophagogastroduodenoscopy, endoscopic ultrasonography, and integrated positron emission tomography/computed tomography scan. Patients with histologically proven malignancy were candidates for surgical procedures. Operability criteria were defined according to the National Comprehensive Cancer Network guidelines. All patients were within the American Society of Anesthesiologists (ASA) class I to III. In general, neoadjuvant chemoradiotherapy was offered to patients with T2-3 or N1-2 disease. The primary endpoint in the first stage is the short-term postoperative complications, and that in the second stage is overall survival; patients continue to be followed up for this endpoint.

日付

最終確認済み: 06/30/2019
最初に提出された: 05/01/2017
提出された推定登録数: 05/01/2017
最初の投稿: 05/03/2017
最終更新が送信されました: 07/10/2019
最終更新日: 07/11/2019
実際の研究開始日: 06/13/2017
一次完了予定日: 07/09/2019
研究完了予定日: 04/03/2024

状態または病気

Clinical or Oncologic Benefits of Robot-assisted IVOR-LEWIS in Esophageal Cancer

段階

-

適格基準

研究の対象となる年齢 18 Years に 18 Years
研究に適格な性別All
サンプリング方法Probability Sample
健康なボランティアを受け入れるはい
基準

Inclusion Criteria:

1. Patients with histologically proven esophageal malignancy

2. All patients were within the American Society of Anesthesiologists (ASA) class I to III

3. neoadjuvant chemoradiotherapy was offered to patients with T2-3 or N1-2 disease

Exclusion Criteria:

Cancer located at the cervical esophageal Cancer located at the gastroesophageal junction history of surgery in the right thorax

結果

主な結果の測定

1. short-term postoperative complications [30 days after surgery]

2. long-term overall survival [five years after surgery]

二次的な結果の測定

1. perioperative outcomes except for postoperative complications [30 days after surgery]

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