Evaluation of minimally invasiveness after radical nontransthoracic esophagectomy for esophagus cancer

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K10490
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Digestive surgery
• Research Institution: The University of Tokyo
• Principal Investigator: Seto Yasuyuki 東京大学, 医学部附属病院, 教授 (00260498)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Keywords: 根治的食道手術 / 低侵襲手術 / 非開胸手術 / ロボット支援下手術 / 術後QOL

Outline of Final Research Achievements

In the present prospective study, we compared perioperative outcomes, postoperative serum cytokine levels, and postoperative respiratory function in the nontransthoracic esophagectomy (NTTE) and transthoracic esophagectomy (TTE) groups, who underwent radical surgery for esophageal cancer. Although the operation time was longer, the incidence of postoperative pneumonia was significantly lower, and the length of postoperative hospital stay was shorter, in the NTTE group than in the TTE group, suggesting that robot-assisted transmediastinal radical esophagectomy can be effective as a minimally invasive surgery for esophageal cancer. The present study revealed that postoperative serum cytokine levels decreased significantly more in the NTTE group than in the TTE group. Respiratory function was better preserved after the NTTE than after the TTE. Moreover, NTTE is associated with better postoperative QOL compared to TTE.

Free Research Field

消化管外科学

Academic Significance and Societal Importance of the Research Achievements

本研究を通して、ロボット支援下非開胸食道亜全摘術は、食道癌手術術後の最も重篤な合併症である術後肺炎の減少に寄与するだけでなく、呼吸機能の保持、長期的な術後QOLの保持が保持されることが示された。我々は食道癌に対する根治的食道切除の低侵襲手術の１型として非開胸手術の有用性を提唱してきており、2018年4月には食道悪性腫瘍に対し、ロボット支援下手術が保険収載されるにまで至っている。