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Research article
Yasuyuki Seto
University of Tokyo Hospital
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The present study aimed to assess the lower invasiveness of robot-assisted transmediastinal radical esophagectomy. We prospectively compared this procedure and the transthoracic esophagectomy in terms of perioperative outcomes, serum cytokine levels, and respiratory function after surgery for esophageal cancer.
Methods
Patients who underwent a robot-assisted transmediastinal esophagectomy or transthoracic esophagectomy between April 2015 and March 2017 were included. The perioperative outcomes, preoperative and postoperative serum IL-6, IL-8, and IL-10 levels, and respiratory function measured preoperatively and at 6 months postoperatively were compared in patients with a robot-assisted transmediastinal esophagectomy and those with a transthoracic esophagectomy.
Results
Sixty patients with esophageal cancer were enrolled. The transmediastinal esophagectomy group had a significantly lower incidence of postoperative pneumonia (p = 0.002) and a significantly shorter postoperative hospital stay (p<0.0002). The serum IL-6 levels on postoperative days 1, 3, 5, and 7 were significantly lower in the transmediastinal esophagectomy group (p=0.005, 0.0007, 0.022, 0.020, respectively). In the transmediastinal esophagectomy group, the serum IL-8 level was significantly lower immediately after surgery and on postoperative day 1 (p=0.003, 0.001, respectively) while the serum IL-10 level was significantly lower immediately after surgery (p=0.041). The reduction in vital capacity, percent vital capacity, forced vital capacity, and forced expiratory volume at 1.0s six months after surgery was significantly greater in the transthoracic esophagectomy group (p<0.0001 for all four measurements).
Conclusions
This prospective study demonstrated that robot-assisted transmediastinal radical esophagectomy can be a minimally invasive surgical procedure for use in radical surgery for esophageal cancer.
Trial registrations
This trial was registered in the UMIN Clinical Trial Registry (UMIN000017565 14/05/2015). https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000020358
Keywords
Esophagus cancer, Esophagectomy, Minimally invasive esophagectomy, Robot-assisted esophagectomy
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CURRENT STATUS: Published
View the published article at BMC Cancer.
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Posted 02 Dec, 2020
No community comments so far
Review #2 received
Received 06 Jan, 2021
Editorial decision: Major revision
On 06 Jan, 2021
Review #1 received
Received 02 Jan, 2021
Reviewer #2 agreed
On 15 Dec, 2020
Reviewer #1 agreed
On 07 Dec, 2020
Reviewers invited
Invitations sent on 04 Dec, 2020
Editor assigned
On 03 Nov, 2020
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On 03 Nov, 2020
Editor invited
On 03 Nov, 2020
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Cancer.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Yasuyuki Seto
University of Tokyo Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Cancer.
Version 1
Posted 02 Dec, 2020
No community comments so far
Review #2 received
Received 06 Jan, 2021
Editorial decision: Major revision
On 06 Jan, 2021
Review #1 received
Received 02 Jan, 2021
Reviewer #2 agreed
On 15 Dec, 2020
Reviewer #1 agreed
On 07 Dec, 2020
Reviewers invited
Invitations sent on 04 Dec, 2020
Editor assigned
On 03 Nov, 2020
Submission checks complete
On 03 Nov, 2020
Editor invited
On 03 Nov, 2020
First submitted
On 25 Oct, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Cancer.
Background
The present study aimed to assess the lower invasiveness of robot-assisted transmediastinal radical esophagectomy. We prospectively compared this procedure and the transthoracic esophagectomy in terms of perioperative outcomes, serum cytokine levels, and respiratory function after surgery for esophageal cancer.
Methods
Patients who underwent a robot-assisted transmediastinal esophagectomy or transthoracic esophagectomy between April 2015 and March 2017 were included. The perioperative outcomes, preoperative and postoperative serum IL-6, IL-8, and IL-10 levels, and respiratory function measured preoperatively and at 6 months postoperatively were compared in patients with a robot-assisted transmediastinal esophagectomy and those with a transthoracic esophagectomy.
Results
Sixty patients with esophageal cancer were enrolled. The transmediastinal esophagectomy group had a significantly lower incidence of postoperative pneumonia (p = 0.002) and a significantly shorter postoperative hospital stay (p<0.0002). The serum IL-6 levels on postoperative days 1, 3, 5, and 7 were significantly lower in the transmediastinal esophagectomy group (p=0.005, 0.0007, 0.022, 0.020, respectively). In the transmediastinal esophagectomy group, the serum IL-8 level was significantly lower immediately after surgery and on postoperative day 1 (p=0.003, 0.001, respectively) while the serum IL-10 level was significantly lower immediately after surgery (p=0.041). The reduction in vital capacity, percent vital capacity, forced vital capacity, and forced expiratory volume at 1.0s six months after surgery was significantly greater in the transthoracic esophagectomy group (p<0.0001 for all four measurements).
Conclusions
This prospective study demonstrated that robot-assisted transmediastinal radical esophagectomy can be a minimally invasive surgical procedure for use in radical surgery for esophageal cancer.
Trial registrations
This trial was registered in the UMIN Clinical Trial Registry (UMIN000017565 14/05/2015). https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000020358
Figure 1
Figure 2
Figure 3
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