초록접수 현황
| 16F-024 | 구연 발표 |
Learning Curve of Bilateral Recurrent Laryngeal Nerve nodes Dissection by Robotic System for Esophageal Cancer
Seong Yong Park, Seokjin Haam, Joonho Jung
Department of Thoracic and Cardiovascular Surgery, Ajou University Hospital, Ajou University School of Medicine, Gyeonggi-do, Korea
Background : Dissection of bilateral recurrent laryngeal nerve (RLN) nodes is an essential but technically demanding procedure in esophageal cancer surgery. The robotic system is known to be useful for RLN node dissection. This retrospective study was performed to investigate the learning curve of bilateral RLN nodes dissection by Robotic system for esophageal cancer.
Methods : We retrospective reviewed the operative outcomes and pathologic results of consecutive 33 patients who received robot esophagectomy and total lymphadenectomy by single surgeon. The patients were divided into two groups; Group 1 (initial 20 cases) and Group 2 (later 13 cases).
Results : The mean age was 61.88 ± 9.03 years with 28 (84.8%) male patients. Almost pathology was squamous cell carcinoma. The location of lesion were 3 (9.1%) in upper, 12 (63.6%) in mid and 9 (27.3%) in lower esophagus. In 32 (97%) patients, R0 resection was achieved. Eleven (33.3%) were stage I, 7 (21.2%) were stage II and 15 (45.5%) were stage III. Operative mortality was developed in 1 (3%) cases in Group 2. The operation time, and robot console time and blood loss was similar between two groups. The time for Rt. and Lt. RLN nodes dissection, the number of total dissected lymph nodes, right RLN nodes and left RLN nods were also comparable. However, the incidence of vocal cord palsy was significantly decreased in Group 2 (55% in Group 1 vs. 0% in Group 2, p=0.02). The incidences of other complications such as pulmonary complications and anastomotic leakages were not different between two groups.
Conclusion : Event though operative outcomes and incidence of other complications were comparable between two groups, the incidence of vocal cord palsy was significantly decreased in Group 2. The minimum 20 cases are required for safe dissection of bilateral RLN nodes with acceptable incidence of vocal cord palsy.
Methods : We retrospective reviewed the operative outcomes and pathologic results of consecutive 33 patients who received robot esophagectomy and total lymphadenectomy by single surgeon. The patients were divided into two groups; Group 1 (initial 20 cases) and Group 2 (later 13 cases).
Results : The mean age was 61.88 ± 9.03 years with 28 (84.8%) male patients. Almost pathology was squamous cell carcinoma. The location of lesion were 3 (9.1%) in upper, 12 (63.6%) in mid and 9 (27.3%) in lower esophagus. In 32 (97%) patients, R0 resection was achieved. Eleven (33.3%) were stage I, 7 (21.2%) were stage II and 15 (45.5%) were stage III. Operative mortality was developed in 1 (3%) cases in Group 2. The operation time, and robot console time and blood loss was similar between two groups. The time for Rt. and Lt. RLN nodes dissection, the number of total dissected lymph nodes, right RLN nodes and left RLN nods were also comparable. However, the incidence of vocal cord palsy was significantly decreased in Group 2 (55% in Group 1 vs. 0% in Group 2, p=0.02). The incidences of other complications such as pulmonary complications and anastomotic leakages were not different between two groups.
Conclusion : Event though operative outcomes and incidence of other complications were comparable between two groups, the incidence of vocal cord palsy was significantly decreased in Group 2. The minimum 20 cases are required for safe dissection of bilateral RLN nodes with acceptable incidence of vocal cord palsy.
책임저자: Seong Yong Park
Department of Thoracic and Cardiovascular Surgery, Ajou University Hospital, Ajou University School of Medicine, Gyeonggi-do, Korea
발표자: Seong Yong Park, E-mail : psy1117@hanmail.net