title: [Initial results of robotic esophagectomy for esophageal cancer].
abstract: BACKGROUND
  There is scant experience with robot-assisted esophagectomy in cases of esophageal and gastro-esophageal junction cancer. Our aim is to report our current experience.
  
  
  METHODS
  Observational cohort study of the first 32 patients who underwent minimally invasive esophagectomy for esophageal cancer from September 2011 to June 2014. The gastric tube was created laparoscopically. In the thoracic field, a robot-assisted thoracoscopic approach was performed in the prone position with intrathoracic robotic hand-sewn anastomosis. Patient and tumour characteristics, surgical technique, short-term outcomes (morbidity and mortality) and oncological results (radicality and number of removed nodes) were evaluated.
  
  
  RESULTS
  Thirty-two patients, with a mean age of 58 years (34-74) were treated by a totally minimally invasive esophagectomy: robotic laparoscopy and thoracoscopy (11 McKeown and 21 Ivor-Lewis). Twenty-nine received neoadjuvant chemoradiotherapy. There were no conversions to open surgery. Console time was 218minutes (190-285). Blood loss was 170ml (40-255). One patient died from cardiac disease. Nine patients had a major complication (Dindo-Clavien grade II or higher). There was no case of respiratory complication or recurrent laryngeal nerve palsy. Five patients had intrathoracic fistula, 4 radiological and one clinical. Three had chylothorax, 2 cervical fistula and one gastric tube necrosis. The median hospital stay was 12 days (8-50). All the resections were R0 and the median of removed lymph nodes was 16 (2-23).
  
  
  CONCLUSIONS
  Our results suggest that minimally invasive esophagectomy with robot-assisted thoracoscopy is safe and achieves oncological standards.
authors: Unidad de Cirugía Esófago-Gástrica, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, España. Electronic address: strugeda@humv.es.
authors: M Soledad
authors: MS
authors: Trugeda Carrera
authors: Unidad de Cirugía Esófago-Gástrica, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, España.
authors: M José
authors: MJ
authors: Fernández-Díaz
authors: Unidad de Cirugía Esófago-Gástrica, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, España.
authors: Juan Carlos
authors: JC
authors: Rodríguez-Sanjuán
authors: Unidad de Cirugía Esófago-Gástrica, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, España.
authors: José Carlos
authors: JC
authors: Manuel-Palazuelos
authors: Unidad de Cirugía Esófago-Gástrica, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, España.
authors: Ernesto Matias
authors: EM
authors: de Diego García
authors: Unidad de Cirugía Esófago-Gástrica, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, España.
authors: Manuel
authors: M
authors: Gómez-Fleitas
mesh_terms: D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D065287:Robotic Surgical Procedures; D016896:Treatment Outcome
keywords: Cirugía robótica; Cáncer de esófago; Esofaguectomía mínimamente invasiva; Esophageal cancer; Minimally invasive esophagectomy; Robotic surgery; Thoracoscopy; Toracoscopia