Surgery today · 2026
Three-region approach for #106recR lymph node dissection during robot-assisted minimally invasive esophagectomy: a reproducible and easily adoptable technique.
СтатьяНазвание и аннотация: Перевод в очереди
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Nakanoko Tomonori, Ohuchida Kenoki, Matsumoto Sokichi, Kawazoe Tetsuro, Tsuda Yasuo, Horioka Kohei, Kubota Saki, Nambara Sho, Otsu Hajime, Hisamatsu Yuichi, Ando Koji, Oki Eiji, Yoshizumi Tomoharu
Аннотация
PURPOSE: To develop a standardized and reproducible technique for #106recR lymph node dissection during robot-assisted minimally invasive esophagectomy (RAMIE) and to elucidate its feasibility and clinical outcomes in comparison with those of minimally invasive esophagectomy (MIE).
METHODS: We developed a three-region approach for #106recR lymph node dissection, dividing the operative field into lateral, nerve branch, and medial areas based on the right recurrent laryngeal nerve (RtRN). A total of 140 patients who underwent curative esophagectomy were included: 70 underwent MIE and 70 underwent RAMIE. Dissection time for #106recR lymph nodes and postoperative outcomes were evaluated.
RESULTS: The median dissection time for #106recR lymph nodes was significantly shorter in the RAMIE group than in the MIE group (25 [12-49] vs. 30 [13-35] min, P < 0.01). When divided into early and late phases, the dissection time significantly decreased in the MIE group (P < 0.01), whereas no significant difference was observed in the RAMIE group (P = 0.27). The number of retrieved #106recR lymph nodes and postoperative complications, including recurrent laryngeal nerve palsy, were comparable between the groups.
CONCLUSIONS: This stepwise approach appears feasible in clinical practice and may help promote consistent operative performance, although further validation is needed.
METHODS: We developed a three-region approach for #106recR lymph node dissection, dividing the operative field into lateral, nerve branch, and medial areas based on the right recurrent laryngeal nerve (RtRN). A total of 140 patients who underwent curative esophagectomy were included: 70 underwent MIE and 70 underwent RAMIE. Dissection time for #106recR lymph nodes and postoperative outcomes were evaluated.
RESULTS: The median dissection time for #106recR lymph nodes was significantly shorter in the RAMIE group than in the MIE group (25 [12-49] vs. 30 [13-35] min, P < 0.01). When divided into early and late phases, the dissection time significantly decreased in the MIE group (P < 0.01), whereas no significant difference was observed in the RAMIE group (P = 0.27). The number of retrieved #106recR lymph nodes and postoperative complications, including recurrent laryngeal nerve palsy, were comparable between the groups.
CONCLUSIONS: This stepwise approach appears feasible in clinical practice and may help promote consistent operative performance, although further validation is needed.