Minimally Invasive and Robotic Surgery in the Surgical Treatment of Esophagogastric Junction Cancer

Publication date: Available online 1 October 2019Source: Cirugía Española (English Edition)Author(s): Ismael Díez del Val, Carlos Loureiro González, José Ignacio Asensio Gallego, Carla Bettonica Larrañaga, Saioa Leturio Fernández, Emma Eizaguirre Letamendia, Mónica Miró Martín, Marta María García Fernández, Laura Martí Gelonch, Humberto Aranda Danso, Julen Barrenetxea Asua, Fernando Estremiana García, Javier Ortiz Lacorzana, Leandre Farran TeixidóAbstractMinimally invasive surgery provides for the treatment of esophagogastric junction tumors under safe conditions, reducing respiratory and abdominal wall complications. Recovery is improved, while maintaining the oncological principles of surgery to obtain an optimal long-term outcome. It is important to have a sufficient volume of activity to progress along the learning curve with close expert supervision in order to guarantee R0 resection and adequate lymphadenectomy. Minimal invasiveness ought not become an objective in itself.Should total gastrectomy be performed, the risk of a positive proximal margin makes intraoperative biopsy compulsory, without ruling out a primary open approach. Meanwhile, minimally invasive esophagectomy has been gaining ground. Its main difficulty, the intrathoracic anastomosis, can be safely carried out either with a mechanical side-to-side suture or a robot-assisted manual suture, thanks to the 3-D vision and versatility of the instruments.ResumenLa cirugía mínimamente invasiva p...
Source: Cirugia Espanola - Category: Surgery Source Type: research